Individual
DR. JOHANNE M POULIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
60 AMIGO RD, WALNUT CREEK, CA 94596
(781) 331-1999
(781) 331-1999
Mailing address
60 AMIGO RD, WALNUT CREEK, CA 94596
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
75025
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
131467
HPHC
MA
01
—
131487
PILGRIM
—
01
—
139147
CIGNA
—
01
—
2649168
AETNA
—
05
—
3097013
—
MA
01
—
75025
TUFTS
—
01
—
J12089
BCBS
MA
Enumeration date
12/02/2005
Last updated
07/08/2007
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