Provider Demographics
NPI:1265842967
Name:KOSKELO, MERRIT ALEXIS HOOVER (MD, PHD)
Entity Type:Individual
Prefix:
First Name:MERRIT
Middle Name:ALEXIS HOOVER
Last Name:KOSKELO
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:MERRIT
Other - Middle Name:ALEXIS
Other - Last Name:HOOVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:710 LAWRENCE EXPY
Mailing Address - Street 2:KAISER PERMANENTE MEDICAL CENTER
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-5173
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:710 LAWRENCE EXPY
Practice Address - Street 2:KAISER PERMANENTE MEDICAL CENTER
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-5173
Practice Address - Country:US
Practice Address - Phone:408-851-3842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-02
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program