Individual
DR. COLLIN TEGUH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2045 ADAMS AVE, SAN DIEGO, CA 92116-1212
(619) 281-8988
(619) 281-0194
Mailing address
2045 ADAMS AVE, SAN DIEGO, CA 92116-1212
(619) 281-8988
(619) 281-0194
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A6332
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX63321
—
CA
Enumeration date
03/17/2006
Last updated
11/13/2020
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