Individual
DR. MICHAEL JACK COULTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 MERCY CIRCLE, CAMP PENDLETON, CA 92055
(760) 725-6646
Mailing address
PO BOX 555191, CAMP PENDLETON, CA 92055-5191
(760) 725-6646
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
A150427
CA
207Y00000X
Otolaryngology Physician
Primary
D7935901
CA
Other
Enumeration date
06/08/2016
Last updated
08/23/2022
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