Organization
CENTRAL CALIFORNIA PEDIATRIC SPECIALTY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANA CAROLINA COLL M.D (CFO)
(559) 280-9165
Entity
Organization
Contact information
Practice address
400 W MINERAL KING AVE, VISALIA, CA 93291-6237
(559) 280-9165
(559) 635-2696
Mailing address
5940 W BUENA VISTA CT, VISALIA, CA 93291-9173
(559) 280-9165
(559) 635-2696
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
A69432
CA
174400000X
Specialist
Primary
A69635
CA
Other
Enumeration date
07/28/2011
Last updated
01/26/2017
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