Individual
JEREMY LEES COOKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4150 V ST, SUITE 2100, SACRAMENTO, CA 95817-1460
(916) 734-8565
Mailing address
4150 V ST STE 2100, SACRAMENTO, CA 95817-1460
(916) 734-8565
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301078100
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104786244
—
MI
Enumeration date
07/10/2006
Last updated
01/04/2022
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