Individual
EDSMOND JERRY COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA PHD
Contact information
Practice address
3 SOUTH LINDEN AVE, SSF, CA 94080
(650) 589-2647
(650) 583-5549
Mailing address
3900 DORAL DR, FAIRFIELD, CA 94533
(707) 425-2824
(707) 425-8970
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10067
CA
Other
Enumeration date
12/29/2006
Last updated
07/08/2007
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