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NPI Code Detail

MEDICARE: CARECONNECTMD GEORGIA PC

MEDICARE: CARECONNECTMD GEORGIA PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1063034387
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARECONNECTMD GEORGIA PC
Provider Business Mailing Address
First Line : 3090 BRISTOL ST STE 200
Second Line :
City : COSTA MESA
State : CA
Zip : 92626-3061
Country : US
Telephone Number : 888-789-9585
Fax Number :
Provider Business Practice Location Address
First Line : 3455 PEACHTREE RD NE FL 5
Second Line :
City : ATLANTA
State : GA
Zip : 30326-3254
Country : US
Telephone Number : 888-789-9585
Fax Number :
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : ORLANDO COLLADO
Credential : MD
Telephone Number : 888-789-9585
Provider Enumeration Date : 05/08/2020
Last Update Date : 11/21/2025

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Directions to “CARECONNECTMD GEORGIA PC ” Practice Location

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