Provider Demographics
NPI:1750347399
Name:COIA, JANICE P (DPM)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:P
Last Name:COIA
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17400 IRVINE BLVD
Mailing Address - Street 2:SUITE H
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3030
Mailing Address - Country:US
Mailing Address - Phone:714-832-7212
Mailing Address - Fax:714-832-0554
Practice Address - Street 1:17400 IRVINE BLVD
Practice Address - Street 2:SUITE H
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3030
Practice Address - Country:US
Practice Address - Phone:714-832-7212
Practice Address - Fax:714-832-0554
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3760213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E37600Medicaid
CAE3760Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
CA000E37600Medicaid