Individual
DR. JASON ELLIS COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1201 W LA VETA AVE, ORANGE, CA 92868
(714) 509-8620
(714) 509-4072
Mailing address
1201 W LA VETA AVE, ORANGE, CA 92868-4203
(714) 509-8620
(714) 509-4072
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
A75756
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2104032
—
MA
01
—
470153
TUFTS HEALTH PLAN
MA
01
—
J28546
BCBS MA
MA
Enumeration date
09/26/2006
Last updated
02/04/2019
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