| David R Couillard, MD | |
|
584 N Sunrise Ave Ste 100, Roseville, CA 95661-2862 | |
| (916) 251-3063 | |
| (916) 459-2403 |
| Full Name | David R Couillard |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 37 Years |
| Location | 584 N Sunrise Ave Ste 100, Roseville, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457462319 | NPI | - | NPPES |
| ZZZ26454Z | Other | CA | MEDICARE GROUP PTAN |
| 00G686510 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | G68651 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Sutter Roseville Medical Center | Roseville, CA | Hospital |
| Sierra Nevada Memorial Hospital | Grass valley, CA | Hospital |
| Mercy San Juan Medical Center | Carmichael, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Javidan Urology Inc | 5496028201 | 5 |
| Sierra Medical Partnership | 7810321858 | 16 |
| Entity Name | Javidan Urology Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174043129 PECOS PAC ID: 5496028201 Enrollment ID: O20170830000801 |
| Entity Name | Sierra Medical Partnership |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568015808 PECOS PAC ID: 7810321858 Enrollment ID: O20191227000310 |
| Mailing Address | Practice Location Address |
|---|---|
| David R Couillard, MD 584 N Sunrise Ave, Ste 100, Roseville, CA 95661-2862 Ph: (916) 251-3063 | David R Couillard, MD 584 N Sunrise Ave Ste 100, Roseville, CA 95661-2862 Ph: (916) 251-3063 |
Dr. Vesna Ivancic Cochell, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 1600 Eureka Rd, Roseville, CA 95661 Phone: 916-784-4000 | |
Dr. Hossein Mirheydar, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 3 Medical Plaza Dr, Ste 250, Roseville, CA 95661 Phone: 916-797-4720 | |
Viswanathan Gajendran, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 1600 Eureka Rd, Roseville, CA 95661 Phone: 916-784-4000 | |
Mr. Abdo J. Faddoul, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 2 Medical Plaza, Suite 285, Roseville, CA 95661 Phone: 916-786-3100 Fax: 916-786-9433 | |
George W. Chiu, MD Urology Medicare: Medicare Enrolled Practice Location: 1600 Eureka Rd, Roseville, CA 95661 Phone: 916-784-4000 | |
John E Gould, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 1130 Conroy Ln, Suite 100, Roseville, CA 95661 Phone: 916-773-5529 Fax: 916-773-0430 | |
Dr. Carolina Raveau Alvayay, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 3 Medical Plaza Dr, Suite 250, Roseville, CA 95661 Phone: 916-797-4719 Fax: 916-797-4721 |