| Koura Md Inc | |
|
751 Medical Center Ct Chula Vista CA 91911-6617 | |
| (619) 794-2521 | |
| (800) 852-5826 |
| Full Name | Koura Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 751 Medical Center Ct, Chula Vista, California |
| Authorized Official Name and Position | Shawn S Koura (PRESIDENT) |
| Authorized Official Contact | 6197942521 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Koura Md Inc 3456 Camino Del Rio N Suite 207 San Diego CA 92108-1713 Ph: (619) 794-2521 | Koura Md Inc 751 Medical Center Ct Chula Vista CA 91911-6617 Ph: (619) 794-2521 |
| NPI Number | 1477900751 |
|---|---|
| Provider Enumeration Date | 05/17/2016 |
| Last Update Date | 10/14/2016 |
| Medicare PECOS PAC ID | 7012209190 |
|---|---|
| Medicare Enrollment ID | O20160711000969 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477900751 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | A125775 (California) | Primary |
| Provider Name | Shawn S Koura |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1407173149 PECOS PAC ID: 8921390006 Enrollment ID: I20160711001034 |
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