DR. KEVIN GOTTLIEB COULOURES


Address: 770 Welch Rd Ste 435, Palo Alto, CA 94304-1511
Phone: 6504986313

DR. KEVIN GOTTLIEB COULOURES (NPI# 1053422147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1053422147
Entity Type Individual
Full Name DR. KEVIN GOTTLIEB COULOURES
Other Name KEVIN GOTTLIEB KETTLER
Credential D.O., MPH
Practice Address 770 Welch Rd Ste 435
Palo Alto
CA 94304-1511
Practice Telephone 6504986313
Mailing Telephone 6504986313
Enumeration Date 2006-08-31
Last Update Date 2019-10-01
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207R00000X Internal Medicine 20A8013 CA Allopathic & Osteopathic Physicians
N 207R00000X Internal Medicine 52487 CT Allopathic & Osteopathic Physicians
N 208000000X Pediatrics 20A8013 CA Allopathic & Osteopathic Physicians
Y 2080P0203X Pediatrics
Specialization: Pediatric Critical Care Medicine
20A8013 CA Allopathic & Osteopathic Physicians
N 2080P0203X Pediatrics
Specialization: Pediatric Critical Care Medicine
52487 CT Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MD 413716700 05
NJ 0147168 05
PA 102040456 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
333 Cedar St, New Haven, CT 065103206 2037854651

Office Location

Street Address 770 WELCH RD STE 435
City PALO ALTO
State CA
Zip Code 94304-1511

Providers in the same location

NPI Name Taxonomy Address Enumeration
1336132224 John Hoang Duong-tran Pediatrics 770 Welch Rd Ste 435, Palo Alto, CA 94304 2005-08-25
1871617621 Timothy Thomas Cornell Pediatrics 770 Welch Rd Ste 435, Palo Alto, CA 94304-1511 2007-03-19
1780657122 Marc David Berg Pediatrics 770 Welch Rd Ste 435, Palo Alto, CA 94304-1511 2006-02-08

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1477170611 Richard Engdahl Specialist/Technologist, Other 820 Quarry Road, Mc1078 Hf006, Palo Alo, CA 94304 2020-07-04
1720603582 Lily Wenya Zhou Psychiatry & Neurology 780 Welch Road, Suite 350, Stanford Stroke Center, Palo Alto, CA 94304 2020-06-08
1033738521 Perry Seo Choi Student in an Organized Health Care Education/Training Program Dept of Cardiothoracic Surgery, Falk Building, 870 Quarry Rd, Palo Alto, CA 94304 2020-04-14
1073150355 Tara Mcdermott Nurse Practitioner 500 Pasteur Drive, Cardiovascular Intensive Care Unit, Palo Alto, CA 94304 2019-12-05
1811542723 Mark Henry Chubb Pediatrics Stanford Children's Health, 725 Welch Road, Palo Alto, CA 94304 2019-08-07
1194285114 Cora Steindl Nurse Practitioner 300 Pasteur Drive Rm H2512, Stanford, CA 94304 2019-03-25
1407333057 Deborah Menet Landi Social Worker Lucile Packard Children's Hospital Stanford, 725 Welch, Mc 5933, Palo Alto, CA 94304 2018-07-26
1982100798 Jonathan Hootman Student in an Organized Health Care Education/Training Program 900 Quarry Road Extension, Palo Alto, CA 94304 2018-04-02
1093234254 Adam C Maclellan Psychiatry & Neurology Stanford Stroke Center, 780 Welch Road, Suite 350, Palo Alto, CA 94304 2017-09-19
1194248153 Chanel Beaudoin Cloutier Plastic Surgery 770 Welch Road, Suite 400, Palo Alto, CA 94304 2017-07-21
Find all providers in zip 94304

Taxonomy Information

Taxonomy Code 2080P0203X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Pediatric Critical Care Medicine

Taxonomy Definition

A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics)

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1679005490 Ala Soofian Pediatrics 725 Welch Rd, Palo Alto, CA 94304-1601 2017-03-30
1447662390 Lara Christina Jones Pediatrics 725 Welch Rd, Palo Alto, CA 94304-1601 2014-05-27
1467776260 Eunice Koh Pediatrics 770 Welch Road, Pediatric Critical Care, Suite 435, Palo Alto, CA 94304 2010-03-23
1144471681 Mihaela Alina Damian Pediatrics 725 Welch Rd, Palo Alto, CA 94304-1601 2008-10-02
1215196050 Katherine Marie Steffen Pediatrics 725 Welch Rd, Palo Alto, CA 94304-1601 2008-06-06
1043487101 Andy Yen-ming Wen Pediatrics 725 Welch Rd, Palo Alto, CA 94304-1601 2008-05-08
1821286857 Natalie Pageler Pediatrics 725 Welch Rd, Palo Alto, CA 94304-1601 2007-10-03
1326248642 Lillian Su Pediatrics 725 Welch Rd, Palo Alto, CA 94304-1601 2007-07-24
1639388994 Azadeh Rose Fayazi Pediatrics 770 Welch Rd, Palo Alto, CA 94304 2007-05-22
1457486300 Michael Joshua Cisco Pediatrics 725 Welch Rd, Packard Childrens Hospital At Stanford, Palo Alto, CA 94304-1601 2007-02-22
Find all providers in PALO ALTO

Competitor

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City PALO ALTO
Zip Code 94304

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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