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Organization
JOHN W. KOETT, M.D., PHD, INC.
Active
Organization
JOHN W. KOETT, M.D., PHD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WILLIAM KOETT MD, PHD (PRESIDENT)
(951) 486-5255
Entity
Organization
Contact information
Practice address
26520 CACTUS AVE, MORENO VALLEY, CA 92555-3927
(951) 486-5255
(951) 486-5270
Mailing address
11730 JOYAS CT, SAN DIEGO, CA 92124-2817
(951) 486-5255
(951) 486-5270
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
NULL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
12/14/2016
Last updated
12/14/2016
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