Colla, Corey B

Colla, Corey B is an individual health care provider with primary practice located at 918 S Fairmont Ave , Lodi CA 95240-5119. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Colla, Corey B can be contacted via phone (209) 366-2001.

Contact Information

Primary practice address
918 S Fairmont Ave Lodi CA 95240-5119
Phone: (209) 366-2001
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X G40722 California

Profile Details

NPI number 1619934809
LBN Legal business name Colla, Corey B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2006
Last updated May 19th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619934809 NPPES
California MEDICAID 00G407220

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