Organization
ROSEVILLE UROLOGY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID RAYMOND COUILLARD MD (CEO)
(916) 768-3290
Entity
Organization
Contact information
Practice address
5 MEDICAL PLAZA DR, SUITE 250, ROSEVILLE, CA 95661-2865
(916) 782-2229
(916) 797-9414
Mailing address
7936 INDIAN SPRINGS WAY, ORANGEVALE, CA 95662
(916) 768-3290
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
G68651
CA
Other
Enumeration date
12/17/2009
Last updated
12/17/2009
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