Individual
MR. HECTOR EDUARDO COLLANTES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
13425 INGLEWOOD AVENUE, HAWTHORNE, CA 90250
(310) 679-2201
(310) 679-4236
Mailing address
824 E CARSON ST, STE 201, CARSON, CA 90745-2262
(310) 326-1579
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA15273
CA
Other
Enumeration date
09/25/2006
Last updated
11/17/2020
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