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Individual

MRS. OTERIA RANDALL KOAYEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1166 BROOKTRAIL DR, 1900 FRUITVALE AVE SUITE 3E, PITTSBURG, CA 94565-7627
(925) 261-9953
Mailing address
1166 BROOKTRAIL DR, PITTSBURG, CA 94565-7627
(925) 261-9953

Taxonomy

Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
15439
CA

Other

Enumeration date
06/14/2007
Last updated
07/08/2007
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