MEDICARE: JODI COATES 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
1	208600000X	Surgery Physician	A93387	CA
2	2086S0127X	Trauma Surgery Physician	A93387	CA
3	2086S0102X	Surgical Critical Care Physician	A93387	CA

General Provider Information

NPI Number	:	1477535714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JODI COATES M.D.

Provider Business Mailing Address
First Line	:	8701 HAMMERSMITH LN
Second Line	:
City	:	FAIR OAKS
State	:	CA
Zip	:	95628-6300
Country	:	US
Telephone Number	:	916-812-9640
Fax Number	:

Provider Business Practice Location Address
First Line	:	555 CAPITOL MALL STE 260
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95814-4503
Country	:	US
Telephone Number	:	916-441-0400
Fax Number	:	916-441-0406

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	04/02/2013

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Directions to “ JODI COATES M.D.” Practice Location

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