Basic Information
| Provider Information | |||||||||
| NPI: | 1477535714 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COATES | ||||||||
| FirstName: | JODI | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8701 HAMMERSMITH LN | ||||||||
| Address2: | |||||||||
| City: | FAIR OAKS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956286300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9168129640 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 555 CAPITOL MALL STE 260 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958144503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164410400 | ||||||||
| FaxNumber: | 9164410406 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/14/2005 | ||||||||
| LastUpdateDate: | 04/02/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | A93387 | CA | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0127X | A93387 | CA | Y | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 2086S0102X | A93387 | CA | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care |
No ID Information.