Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | A122537 | CA |
N | 208000000X | Pediatrician | A122537 | CA |
NPI | 1205128089 |
---|---|
Provider Name | Cathleen Ann Collins |
First Address | San Diego, CA 92123-4223 |
Second Address | San Diego, CA 92123-4232 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2011 |
Last Update Date | 01/09/2021 |