MEDICARE: DONNA FELKER CODY M.S.

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	231H00000X	Audiologist	AU1223	CA

General Provider Information

NPI Number	:	1760453880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA FELKER CODY M.S.

Provider Business Mailing Address
First Line	:	4132 SHORECREST LN
Second Line	:
City	:	CORONA DEL MAR
State	:	CA
Zip	:	92625-2630
Country	:	US
Telephone Number	:	949-219-9969
Fax Number	:

Provider Business Practice Location Address
First Line	:	3409 E COAST HWY
Second Line	:
City	:	CORONA DEL MAR
State	:	CA
Zip	:	92625-2432
Country	:	US
Telephone Number	:	949-675-3833
Fax Number	:

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

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	07/08/2007

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