Provider Demographics
NPI:1598932436
Name:N P COLLER HOLDING
Entity type:Organization
Organization Name:N P COLLER HOLDING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:J
Authorized Official - Last Name:COLLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-459-3305
Mailing Address - Street 1:1040 GENTER ST
Mailing Address - Street 2:103
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-5546
Mailing Address - Country:US
Mailing Address - Phone:858-459-3305
Mailing Address - Fax:858-459-0855
Practice Address - Street 1:7616 GIRARD AVE
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4420
Practice Address - Country:US
Practice Address - Phone:858-459-3305
Practice Address - Fax:858-459-0855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit