Provider Demographics
NPI:1851380315
Name:COATES, LYNN P (MD)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:P
Last Name:COATES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 E CARSON ST
Mailing Address - Street 2:NUMBER 201
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745-2262
Mailing Address - Country:US
Mailing Address - Phone:310-233-3228
Mailing Address - Fax:310-233-3229
Practice Address - Street 1:824 E CARSON ST
Practice Address - Street 2:NUMBER 201
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-2262
Practice Address - Country:US
Practice Address - Phone:310-233-3228
Practice Address - Fax:310-233-3229
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA35617207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW19860Medicare ID - Type UnspecifiedGROUP ID
A84795Medicare UPIN
CAWA35617EMedicare ID - Type UnspecifiedPPIN