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1619934809
COREY B COLLA
LODI, CA
NPI
1619934809
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: CA G40722)
Enumeration Date
2006-05-01
Last Update Date
2016-05-19
Business Address
-- COREY B COLLA MD
918 S FAIRMONT AVE
LODI, CA 95240-5119
Phone number: 209-366-2001
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Mailing Address
-- COREY B COLLA MD
600 COFFEE RD
MODESTO, CA 95355-4201
Phone number: 209-521-6097
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