Individual
DAVID R COUILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
584 N SUNRISE AVE STE 100, ROSEVILLE, CA 95661-2862
(916) 251-3063
(916) 459-2403
Mailing address
584 N SUNRISE AVE, STE 100, ROSEVILLE, CA 95661-2862
(916) 251-3063
(916) 459-2403
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
G68651
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G686510
—
CA
01
—
ZZZ26454Z
MEDICARE GROUP PTAN
CA
Enumeration date
08/31/2006
Last updated
01/23/2020
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