Individual
DR. TYSON COBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1140 W LA VETA AVE, SUITE 640, ORANGE, CA 92868
(714) 564-3300
(949) 231-5112
Mailing address
1140 W LA VETA AVE, SUITE 640, ORANGE, CA 92868
(714) 564-3300
(714) 564-3318
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
C35334
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060065322
RAILROAD MEDICARE
CA
01
—
DB3373
RAILROAD MEDICARE
CA
01
—
W13988
MEDICARE PTAN
CA
01
—
W13988A
MEDICARE PTAN
CA
Enumeration date
06/14/2005
Last updated
07/15/2021
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