MEDICARE: DR. CAROL ASHLEY COATNEY DAOM

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	171100000X	Acupuncturist	AC15413	CA

General Provider Information

NPI Number	:	1700649662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROL ASHLEY COATNEY DAOM

Provider Business Mailing Address
First Line	:	1715 S CAESAR AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93727-5914
Country	:	US
Telephone Number	:	559-307-8059
Fax Number	:

Provider Business Practice Location Address
First Line	:	1715 S CAESAR AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93727-5914
Country	:	US
Telephone Number	:	559-307-8059
Fax Number	:

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

Provider Enumeration Date	:	02/02/2024
Last Update Date	:	02/02/2024

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