Robert a Collen M D Medical Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G21229 Issued in CA

Legal business name

ROBERT A COLLEN M D MEDICAL CORPORATION

Practice address

10802 College PL
Cerritos, CA 90703-1505

Phone

(562) 904-3998

Fax

(562) 924-6523

NPI assigned

Dec 29, 2010

Organization subpart

No

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

Authorized official

Name

Robert A. Collen, M.D.

Title

Ceo

Phone

(714) 397-0768

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1293580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432252800000",
    "number": "1952605271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10802 COLLEGE PL",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907031505",
            "telephone_number": "714-397-0768",
            "fax_number": "714-955-5394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10802 COLLEGE PL",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907031505",
            "telephone_number": "562-904-3998",
            "fax_number": "562-924-6523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT A COLLEN M D MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-29",
        "last_updated": "2015-05-22",
        "status": "A",
        "authorized_official_last_name": "COLLEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-397-0768",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G21229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1 NPI",
            "identifier": "1538267125",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Cerritos, CA
• Providers in Cerritos, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2015; 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.