Individual
MR. TEDDY COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
536 W. VISTA WAY, VISTA, CA 92083
(760) 758-1650
Mailing address
536 W. VISTA WAY, VISTA, CA 92083
(760) 758-1650
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-PFGARE
CA
Other
Enumeration date
10/09/2024
Last updated
04/27/2026
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