Provider Demographics
NPI:1659554715
Name:COTE, MICHELLE ANN (PAC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANN
Last Name:COTE
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6367 ALVARADO CT STE 107
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-4914
Mailing Address - Country:US
Mailing Address - Phone:619-287-1882
Mailing Address - Fax:619-287-4121
Practice Address - Street 1:6367 ALVARADO CT STE 107
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-4914
Practice Address - Country:US
Practice Address - Phone:619-287-1882
Practice Address - Fax:619-287-4121
Is Sole Proprietor?:No
Enumeration Date:2007-12-12
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC05724363AM0700X
AZ3757363AM0700X
CA51219363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical