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General NPI Number Information
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NPI Number | 1740349372
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Entity Type | Individual
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Provider Name | VIDHYALAKSHMI KOKA MD
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Gender | Female
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 07/19/2021
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Provider Practice Location Address
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Address Line | 422 N SAN JACINTO ST
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City | HEMET
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State | CA
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Zip | 92543-3124
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Country | US
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Telephone | 941-665-1100
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Fax | 888-696-2590
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Provider Business Mailing Address
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Address Line | 422 N SAN JACINTO ST
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City | HEMET
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State | CA
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Zip | 92543-3124
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Country | US
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Telephone | 941-665-1100
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Fax | 888-696-2590
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A60821
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A60821
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A60821
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License Number State | CA
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