Organization Name: | DYAN M. COLE MD, INC |
NPI Number: | 1124288360 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DYAN M COLE (OWNER) |
Mailing Address: | 401 S Glenoaks Blvd Ste. # 203b Burbank |
State: | CA US |
Postal Code: | 915021448 |
Phone Number: | 8185597295 |
Fax Number: | 8188419068 |
NPI Enumeration Date: | 06/11/2008 |
NPI Last Update Date: | 06/11/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |