Provider Demographics
NPI:1700426558
Name:DANIEL COULTER, M.D. INC.
Entity Type:Organization
Organization Name:DANIEL COULTER, M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:COULTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-252-4989
Mailing Address - Street 1:28 ARROYO VISTA DR
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-1071
Mailing Address - Country:US
Mailing Address - Phone:805-252-4989
Mailing Address - Fax:
Practice Address - Street 1:801 SENECA ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93001-1411
Practice Address - Country:US
Practice Address - Phone:805-653-6434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty