institution
Colonial Corner Medical Group, Inc.
Specialist in San Diego, California
NPI 1669596557

Colonial Corner Medical Group, Inc. is a Specialist based in San Diego, CA. Colonial Corner Medical Group, Inc. practices in San Diego, CA. The NPI Number for Colonial Corner Medical Group, Inc. is 1669596557 and holds a License No. G86752 (California).

The current practice location address for Colonial Corner Medical Group, Inc. is 4440 Euclid Ave # C, San Diego, CA and can be reached out via phone at 619-582-5105 and via fax at 619-582-5121.

Location: 4440 Euclid Ave # C, San Diego, CA, 92115-4522
institution
Provider Profile Details
NPI Number
1669596557
Provider Name
Colonial Corner Medical Group, Inc.
Credential
Provider Entity Type
Organization
Address
4440 Euclid Ave # C, San Diego, CA, 92115-4522
Phone Number
619-582-5105
Fax Number
619-582-5121
Provider Enumeration Date
03/18/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
GR0094010 01 CA MEDI-CAL
W17287 01 CA PTAN
institution
Provider Business Practice Location Address Details
Address
4440 Euclid Ave # C
City
State
Zip
92115-4522
Phone Number
619-582-5105
Fax Number
619-582-5121
person
Provider Business Mailing Address Details
Address
4440 Euclid Ave # C
City
State
Zip
92115-4522
Phone Number
619-582-5105
Fax Number
619-582-5121
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
License No.
G86752 (California)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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