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General NPI Number Information
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NPI Number | 1346228087
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Entity Type | Individual
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Provider Name | PHILIP D. COTTER PHD, FACMG
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Gender | Male
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Dates
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Enumeration Date | 01/04/2006
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Last Update Date | 07/11/2014
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Provider Practice Location Address
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Address Line | 5 MASON LANE SUITE 100
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City | IRVINE
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State | CA
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Zip | 92618-2552
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Country | US
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Telephone | 949-812-6902
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Fax | 949-297-3983
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Provider Business Mailing Address
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Address Line | 5 MASON LANE SUITE 100
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City | IRVINE
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State | CA
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Zip | 92618-2552
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Country | US
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Telephone | 949-812-7363
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207SC0300X
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Taxonomy Name | Clinical Cytogenetics Physician
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License Number | DRM1
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207SG0203X
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Taxonomy Name | Clinical Molecular Genetics Physician
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License Number | DRN1
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207SC0300X
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Taxonomy Name | Clinical Cytogenetics Physician
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License Number | DRM00000001
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207SG0203X
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Taxonomy Name | Clinical Molecular Genetics Physician
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License Number | DRM00000001
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License Number State | CA
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