Provider Demographics
NPI:1528245602
Name:EMMETT COX II, M.D., A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:EMMETT COX II, M.D., A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMMETT
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:310-519-3146
Mailing Address - Street 1:1360 W 6TH ST
Mailing Address - Street 2:WEST BLDG. #245
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90732-3514
Mailing Address - Country:US
Mailing Address - Phone:310-519-3146
Mailing Address - Fax:
Practice Address - Street 1:1360 W 6TH ST
Practice Address - Street 2:WEST BLDG. #245
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90732-3514
Practice Address - Country:US
Practice Address - Phone:310-519-3146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-30
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG56874207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty