Diane J Coker, P.T.

Individual provider Active NPI Specialist · Laguna Woods, CA

NPI 1194720474 · NPPES record last updated Sep 21, 2010

Key facts

NPI
1194720474
Entity type
Individual (NPI type 1)
Primary specialty
Specialist 174400000X
License
PT08251 (CA)
Practice address
24331 El Toro Rd
Ste 200
Laguna Woods, CA 92637-2753
Phone
(949) 586-3200
Fax
(949) 900-2136
NPI assigned
Jun 14, 2005
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PT08251CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
South County Orthopedic Specialists Specialist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT08251 CA Yes

Addresses

Primary practice location

24331 El Toro Rd
Ste 200
Laguna Woods, CA 92637-2753

Mailing address

PO Box 31063
Laguna Hills, CA 92654-1063
Phone (949) 586-3200

Other identifiers

IdentifierTypeStateIssuer
9105000224OtherCACERTIFIED HAND THERAPIST

Other names

  • Diane Autrey Coker Professional name

Other providers in Laguna Woods, CA

All providers in Laguna Woods, CA · Specialist in California

Sources for this page

Verify at the official NPI Registry.