Provider Demographics
NPI:1255590535
Name:COONS, HAROLD GEORGE (MD)
Entity type:Individual
Prefix:
First Name:HAROLD
Middle Name:GEORGE
Last Name:COONS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2936 CALLE DE MALIBU
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-5811
Mailing Address - Country:US
Mailing Address - Phone:760-703-3348
Mailing Address - Fax:
Practice Address - Street 1:2936 CALLE DE MALIBU
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92029-5811
Practice Address - Country:US
Practice Address - Phone:760-703-3348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA222434261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology