Individual
WAYNE A.L. KOLL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
963 BUTTE ST, REDDING, CA 96001-0828
(530) 245-5900
(530) 245-5909
Mailing address
PO BOX 994032, REDDING, CA 96099-4032
(530) 241-0473
(530) 241-5377
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
A67556
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A675560
—
CA
Enumeration date
07/20/2005
Last updated
07/08/2007
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