| NPI | 1669596557 |
|---|---|
| Other Name | COLONIAL CORNER MEDICAL GROUP, INC. |
| Entity Type | Organization |
| Authorized Contact | ELIZABETH DAVID Finance Manager 619-582-5105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA G86752) |
| Enumeration Date | 2007-03-18 |
| Last Update Date | 2022-07-21 |