Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 31907 | CA |
Y | 213EG0000X | General Practice | 31907 | CA |
NPI | 1003018383 |
---|---|
Provider Name | Dr. Rodney Michael Collins |
First Address | Redlands, CA 92373 |
Second Address | Redlands, CA 92373-4609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2007 |
Last Update Date | 08/07/2007 |