Individual
MR. RICHARD WILLIAM COOKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
624 E ELDER STREET, FALLBROOK, CA 92028
(760) 728-1191
Mailing address
PO BOX 522, IA, FALLBROOK, CA 92088
(760) 491-0072
(760) 451-9072
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
403376
CA
367500000X
Certified Registered Nurse Anesthetist
58039
KY
Other
Enumeration date
09/28/2006
Last updated
09/25/2020
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