Individual
DR. KYLE WAYNE COKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
24331 EL TORO RD STE 200, LAGUNA WOODS, CA 92637-3116
(949) 586-3200
(949) 900-2116
Mailing address
24331 EL TORO RD STE 200, LAGUNA WOODS, CA 92637-3116
(949) 586-3200
(949) 900-2116
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
G36807
CA
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
G36807
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G368070
—
CA
01
—
00G368070G89
CAL-OPTIMA
CA
01
—
RR2000 22926
MEDICARE RAILROAD
CA
Enumeration date
06/13/2005
Last updated
06/16/2020
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