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Individual

DR. MICHAEL J COUGHLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
400 PARNASSUS AVE, SAN FRANCISCO, CA 94143-2202
(415) 476-1000
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 367-3330
(208) 367-3331

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
G30774
CA
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
G30774
CA
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
M3906
ID

Other

Enumeration date
08/11/2005
Last updated
05/15/2018
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