Organization · Type 2 NPI

Colonial Corner Medical Group, Inc.

Specialist · San Diego, CA

NPI number 1669596557 Active

Practice location

4440 Euclid Ave # C
San Diego, CA 92115-4522

Fax (619) 582-5121

Specialties and licenses

Taxonomy	Code	License
Specialist Primary	174400000X	G86752 (CA)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Another provider at this address

Nadine Elaine Sidrick, MDGeneral Practice Physician San Diego, CA NPI 1134140718

Other specialist providers in San Diego

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NPI record

NPI: 1669596557
Entity type: Organization (Type 2)
Issued: Mar 18, 2007
Last updated: Jul 21, 2022
Status: Active

Other names

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Colonial Corner Medical Group, Inc. · other name
Colonial Corner Medical Group, Inc. · other name

Authorized official

Mrs. Elizabeth David
Finance Manager
(619) 582-5105

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1669596557

Colonial Corner Medical Group, Inc.'s National Provider Identifier is 1669596557, issued on Mar 18, 2007. The primary taxonomy on file is Specialist (174400000X), and the practice location is in San Diego, CA. The record was last updated on Jul 21, 2022.