Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | ||
N | 222Z00000X | Podiatrist | ||
Y | 224P00000X | Prosthetist |
NPI | 1245548775 |
---|---|
Provider Name | Mr. Robert A Cook |
First Address | Oroville, CA 95965-5815 |
Second Address | Oroville, CA 95965-5815 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2010 |
Last Update Date | 28/11/2012 |