Provider Demographics
NPI:1598721318
Name:COGGINS, DWAIN L (MD)
Entity Type:Individual
Prefix:
First Name:DWAIN
Middle Name:L
Last Name:COGGINS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2490 HOSPITAL DR
Mailing Address - Street 2:STE 311
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4126
Mailing Address - Country:US
Mailing Address - Phone:408-879-5900
Mailing Address - Fax:408-490-1636
Practice Address - Street 1:2400 SAMARITAN DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-3910
Practice Address - Country:US
Practice Address - Phone:408-879-5900
Practice Address - Fax:408-490-1636
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2020-12-04
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Provider Licenses
StateLicense IDTaxonomies
CAG58266207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA26-3374042OtherTAX ID
CAG58266OtherCA MED LICENSE
CAF23997Medicare UPIN