Provider Demographics
NPI:1528211364
Name:LAUREEN COTA, DPM, PLLC
Entity Type:Organization
Organization Name:LAUREEN COTA, DPM, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPM
Authorized Official - Prefix:DR
Authorized Official - First Name:LAUREEN
Authorized Official - Middle Name:GABRIELLE
Authorized Official - Last Name:COTA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:602-432-7637
Mailing Address - Street 1:1821 N. TREKELL RD SUITE 2
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122
Mailing Address - Country:US
Mailing Address - Phone:602-377-1007
Mailing Address - Fax:480-855-5575
Practice Address - Street 1:1821 N. TREKELL RD SUITE 2
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122
Practice Address - Country:US
Practice Address - Phone:602-377-1007
Practice Address - Fax:480-855-5575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-24
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0644213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty