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Individual

DR. CARLA COLLINS GORUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1820 41ST AVE, SUITE D, CAPITOLA, CA 95010-2516
(831) 476-3000
(831) 476-9009
Mailing address
3400 DATA DR, RANCHO CORDOVA, CA 95670-7956
(916) 379-2915

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A86939
CA

Other

Enumeration date
09/29/2005
Last updated
11/02/2012
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