Individual
COLLINS PIVADGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 BODIN CIR BLDG 777, TRAVIS AFB, CA 94535-1809
(707) 423-7899
Mailing address
2780 N TEXAS ST APT 257, FAIRFIELD, CA 94533-7307
(678) 847-3832
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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