Individual
DEBRA LYNN COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2131 W 3RD ST, LOS ANGELES, CA 90057-1901
(310) 484-7600
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(310) 996-0363
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA15098
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA15098
STATE LICENSE
CA
Enumeration date
07/19/2007
Last updated
03/17/2018
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