Individual provider Active NPI

Colleen P McNally, MD

  • Obstetrics & Gynecology Physician
  • San Diego, CA
National Provider Identifier
1114039062
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
G74059 Issued in CA
Practice address
8010 Frost St
#301
San Diego, CA 92123
Phone
(858) 292-7200
Fax
(858) 505-0304
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X G74059 CA Primary

Addresses

Primary practice location

8010 Frost St
#301
San Diego, CA 92123

Mailing address

8010 Frost St
#301
San Diego, CA 92123
Phone (858) 292-7200

Other identifiers 1

IdentifierTypeStateIssuer
00G740590MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080422000862 CA Practitioner - Obstetrics/Gynecology 9133207707 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G74059CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California CurrentSince Jan 7, 2019 Accepting new patients
Regents of the University of California Obstetrics & Gynecology CurrentSince Jan 7, 2019 Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation Past Accepting new patients

Locations

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

3750 Convoy St
Ste 312
San Diego, CA 92111
Phone (858) 292-7200

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1114039062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8010 FROST ST",
            "address_2": "#301",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92123",
            "telephone_number": "858-292-7200",
            "fax_number": "858-505-0304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8010 FROST ST",
            "address_2": "#301",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92123",
            "telephone_number": "858-292-7200",
            "fax_number": "858-505-0304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNALLY",
        "first_name": "COLLEEN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G74059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G740590",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.