# JOHN W. KOETT, M.D., PHD, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306380092
- **Authorized official:** JOHN WILLIAM KOETT MD, PHD (PRESIDENT)
- **Authorized official phone:** (951) 486-5255

## Contact information

- **Practice address:** 26520 CACTUS AVE, MORENO VALLEY, CA 92555-3927
- **Practice address phone:** (951) 486-5255
- **Practice address fax:** (951) 486-5270
- **Mailing address:** 11730 JOYAS CT, SAN DIEGO, CA 92124-2817
- **Mailing address phone:** (951) 486-5255
- **Mailing address fax:** (951) 486-5270

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/14/2016
- **Last updated:** 12/14/2016