Basic Information
| Provider Information | |||||||||
| NPI: | 1831205426 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COWARD | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | BYRON | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 222 PALISADES SIERRA OAKS LANE | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958258229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9169475691 | ||||||||
| FaxNumber: | 9167338741 | ||||||||
| Practice Location | |||||||||
| Address1: | 2801 K ST STE 310 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958165119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164546677 | ||||||||
| FaxNumber: | 9167338741 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2006 | ||||||||
| LastUpdateDate: | 02/03/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | G39598 | CA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XX0005X | G39598 | CA | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine |
ID Information
| ID | Type | State | Issuer | Description | 170865900 | 01 | CA | US DEPT OF LABOR | OTHER | 200003438 | 01 | CA | RAILROAD MEDICARE # | OTHER | ZZZ00355Z | 01 | CA | BLUE SHIELD OF CALIF. | OTHER | GR0064540 | 05 | CA | MEDICAID |