Individual
DR. LAURA L. KOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
400 PARNASSUS AVE, SAN FRANCISCO, CA 94143-2202
(415) 353-2961
(415) 353-2568
Mailing address
1635 DIVISADERO STREET, SUITE 625, BOX 1821, SAN FRANCISCO, CA 94143-0001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A64672
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
A64672
CA
207RP1001X
Pulmonary Disease Physician
Primary
A64672
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0A6467200
—
CA
Enumeration date
04/20/2006
Last updated
09/11/2008
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