Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | G44540 | CA |
NPI | 1811095862 |
---|---|
Provider Name | Dr. John Jerome Coyle JR. |
First Address | West Hills, CA 91304-2155 |
Second Address | West Hills, CA 91304-2155 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 05/01/2015 |