Colonial Corner Medical Group, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

G86752 Issued in CA

Legal business name

COLONIAL CORNER MEDICAL GROUP, INC.

Practice address

4440 Euclid Ave # C
San Diego, CA 92115-4522

Phone

(619) 582-5105

Fax

(619) 582-5121

NPI assigned

Mar 18, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Elizabeth David I

Title

Finance Manager

Phone

(619) 582-5105

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Colonial Corner Medical Group, Inc. Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hope H McGinn, PA-C

  • Physician Assistant
  • San Diego, CA
  • NPI 1891105516
  NPD

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

{
    "created_epoch": "1174176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1669596557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 EUCLID AVE # C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154522",
            "telephone_number": "619-582-5105",
            "fax_number": "619-582-5121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 EUCLID AVE # C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154522",
            "telephone_number": "619-582-5105",
            "fax_number": "619-582-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL CORNER MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-18",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "DAVID",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "FINANCE MANAGER",
        "authorized_official_telephone_number": "619-582-5105",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_name_suffix": "I"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G86752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "GR0094010",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "W17287",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colonial Corner Medical Group, Inc.",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Colonial Corner Medical Group, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Arriannebelle A Coloma
• Sabina Colombeau
• Linda Maddalena Colombini, M.D.
• Marina S.L. Colombo, M.D.
• Euris Colon
• Amy Colony
• Michael Colorado
• Zaida Colores
• Melanie Noelle Cruz Colorina
• Christopher Colp

• Specialist in San Diego, CA
• Providers in San Diego, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.