Provider Demographics
NPI:1093057564
Name:COOK, NOAH EAMON (MD)
Entity Type:Individual
Prefix:DR
First Name:NOAH
Middle Name:EAMON
Last Name:COOK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:NOAH
Other - Middle Name:EAMON
Other - Last Name:MOON-COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1300 ETHAN WAY STE 600
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-2296
Mailing Address - Country:US
Mailing Address - Phone:916-482-7623
Mailing Address - Fax:916-482-3647
Practice Address - Street 1:5 MEDICAL PLAZA DR STE 190
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-2867
Practice Address - Country:US
Practice Address - Phone:916-786-7498
Practice Address - Fax:916-786-2715
Is Sole Proprietor?:No
Enumeration Date:2013-03-22
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA142961207RP1001X, 208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine