Individual provider Active NPI

Kyle Wayne Coker, M.D.

  • Orthopaedic Hand Surgery Physician
  • Laguna Woods, CA
National Provider Identifier
1265436620
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
G36807 Issued in CA
Practice address
24331 El Toro Rd Ste 200
Laguna Woods, CA 92637-3116
Phone
(949) 586-3200
Fax
(949) 900-2116
NPI assigned
Jun 13, 2005
Last updated
Jun 16, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X G36807 CA
Orthopaedic Hand Surgery Physician 207XS0106X G36807 CA Primary

Addresses

Primary practice location

24331 El Toro Rd Ste 200
Laguna Woods, CA 92637-3116

Mailing address

24331 El Toro Rd Ste 200
Laguna Woods, CA 92637-3116
Phone (949) 586-3200

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36807CAMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592265600000",
    "number": "1265436620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24331 EL TORO RD STE 200",
            "city": "LAGUNA WOODS",
            "state": "CA",
            "postal_code": "926373116",
            "telephone_number": "949-586-3200",
            "fax_number": "949-900-2116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24331 EL TORO RD STE 200",
            "city": "LAGUNA WOODS",
            "state": "CA",
            "postal_code": "926373116",
            "telephone_number": "949-586-3200",
            "fax_number": "949-900-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COKER",
        "first_name": "KYLE",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G36807",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "CA",
            "license": "G36807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Woods, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.