Provider Demographics
NPI:1245410588
Name:KOONTZ, MICHAEL ZACH (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ZACH
Last Name:KOONTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5 HARRIS CT BLDG T
Mailing Address - Street 2:201
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5750
Mailing Address - Country:US
Mailing Address - Phone:831-375-4105
Mailing Address - Fax:831-655-1277
Practice Address - Street 1:5 HARRIS CT BLDG T
Practice Address - Street 2:201
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5750
Practice Address - Country:US
Practice Address - Phone:831-375-4105
Practice Address - Fax:831-655-1277
Is Sole Proprietor?:No
Enumeration Date:2007-11-04
Last Update Date:2014-07-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA105130207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine