Organization
COCOON MEDICAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERIF ABDALLA MD (OWNER)
(323) 359-4898
Entity
Organization
Contact information
Practice address
11302 N VIA SAN TOMA DR, FRESNO, CA 93730-9740
(323) 359-4898
Mailing address
11302 N VIA SAN TOMA DR, FRESNO, CA 93730-9740
(323) 359-4898
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A-101952
PHYSICAL MEDICINE & REHABILITATION PAIN MEDICINE
TX
01
—
FA3880045
PHYSICAL MEDICINE & REHABILITATION PAIN MEDICINE
TX
Enumeration date
03/03/2022
Last updated
03/04/2022
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