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
—
—
Other
Enumeration date
12/14/2016
Last updated
12/14/2016
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