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Organization
FRANK J COLLIE MD MEDICAL CORPORATION
Active
Organization
FRANK J COLLIE MD MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK J. COLLIE M.D. (OWNER)
(805) 543-8310
Entity
Organization
Contact information
Practice address
148 CASA ST, SAN LUIS OBISPO, CA 93405-1804
(805) 543-8310
(805) 543-3754
Mailing address
148 CASA ST, SAN LUIS OBISPO, CA 93405-1804
(805) 543-8310
(805) 543-3754
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
Z11763
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020419
CITY OF SAN LUIS OBISPO B
CA
01
—
Z11763
CERTIFICATE OF REGISTRATI
CA
Enumeration date
07/26/2007
Last updated
08/19/2008
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