Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | G43782 | CA |
NPI | 1225107691 |
---|---|
Provider Name | Jeffrey D Coe |
First Address | Los Gatos, CA 95032-1418 |
Second Address | Los Gatos, CA 95032-1418 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 15/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D76718 | (02) | CA |
ZZZ03772Z | MEDICARE GROUP (01) | CA |