Organization Active NPI

Nancy R. Kollisch, M.D., Inc.

  • Infectious Disease Physician
  • San Diego, CA
National Provider Identifier
1588870802
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
G44466 Issued in CA
Legal business name
NANCY R. KOLLISCH, M.D., INC.
Practice address
8008 Frost St
Suite 445
San Diego, CA 92123-4205
Phone
(619) 296-9883
Fax
(619) 296-4930
NPI assigned
May 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Nancy Ruth Kollisch, M.D.
Title
President
Phone
(619) 296-9883

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X G44466 CA Primary

Addresses

Primary practice location

8008 Frost St
Suite 445
San Diego, CA 92123-4205

Mailing address

8008 Frost St
Suite 445
San Diego, CA 92123-4205
Phone (619) 296-9883

Other identifiers 1

IdentifierTypeStateIssuer
00G444660MedicaidCA

National Provider Directory

National Provider Directory

Locations

8008 Frost St
Ste 445
San Diego, CA 92123
Phone (619) 296-9883

8008 Frost St
Ste 20
San Diego, CA 92123
Phone (619) 296-9883

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1588870802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8008 FROST ST",
            "address_2": "SUITE 445",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234205",
            "telephone_number": "619-296-9883",
            "fax_number": "619-296-4930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8008 FROST ST",
            "address_2": "SUITE 445",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234205",
            "telephone_number": "619-296-9883",
            "fax_number": "619-296-4930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NANCY R. KOLLISCH, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOLLISCH",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "RUTH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-296-9883",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "G44466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G444660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.