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NPI Code Detail

MEDICARE: DR. KYLE WAYNE COKER M.D.

MEDICARE:  DR. KYLE WAYNE COKER  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery PhysicianG36807CA
2207XS0106XOrthopaedic Hand Surgery PhysicianG36807CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RR2000 22926OTHERCAMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
200G368070G89OTHERCACAL-OPTIMA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265436620
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KYLE WAYNE COKER M.D.
Provider Business Mailing Address
First Line : 24331 EL TORO RD STE 200
Second Line :
City : LAGUNA WOODS
State : CA
Zip : 92637-3116
Country : US
Telephone Number : 949-586-3200
Fax Number : 949-900-2116
Provider Business Practice Location Address
First Line : 24331 EL TORO RD STE 200
Second Line :
City : LAGUNA WOODS
State : CA
Zip : 92637-3116
Country : US
Telephone Number : 949-586-3200
Fax Number : 949-900-2116
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 06/16/2020

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