Provider Demographics
NPI:1689941171
Name:COULMAN, CATHLEEN UNDERWOOD (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHLEEN
Middle Name:UNDERWOOD
Last Name:COULMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MARITIME ACADEMY DRIVE
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590
Mailing Address - Country:US
Mailing Address - Phone:707-654-1170
Mailing Address - Fax:707-654-1171
Practice Address - Street 1:200 MARITIME ACADEMY DR
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-8181
Practice Address - Country:US
Practice Address - Phone:707-654-1170
Practice Address - Fax:707-654-1171
Is Sole Proprietor?:No
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG57385207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine