Provider Demographics
NPI:1568817450
Name:DUNN, COLIN PATRICK (MD)
Entity type:Individual
Prefix:DR
First Name:COLIN
Middle Name:PATRICK
Last Name:DUNN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1484 POLLARD RD # 3028
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1031
Mailing Address - Country:US
Mailing Address - Phone:669-240-0616
Mailing Address - Fax:
Practice Address - Street 1:14911 NATIONAL AVE STE 1
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2632
Practice Address - Country:US
Practice Address - Phone:669-240-0616
Practice Address - Fax:408-688-2505
Is Sole Proprietor?:No
Enumeration Date:2016-04-27
Last Update Date:2024-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD477569208600000X
CAA186661208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
15588772OtherCAQH