Individual
CASEY MCCOLLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1902 ROYALTY DR, SUITE 130, POMONA, CA 91767-3030
(909) 865-5777
(909) 865-5781
Mailing address
1902 ROYALTY DR, SUITE 130, POMONA, CA 91767-3030
(909) 865-5777
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA22463
CA
Other
Enumeration date
08/29/2012
Last updated
01/13/2014
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