Healthcare Provider Details

I. General information

NPI: 1508977364
Provider Name (Legal Business Name): R DOUGLAS COLLINS, M.D. INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 01/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 W RAMSEY ST # A
BANNING CA
92220-4442
US

IV. Provider business mailing address

PO BOX 1509
BANNING CA
92220-0011
US

V. Phone/Fax

Practice location:
  • Phone: 951-849-2526
  • Fax: 951-849-9107
Mailing address:
  • Phone: 951-849-2526
  • Fax: 951-849-9107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA41586
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA41586
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA41586
License Number StateCA

VIII. Authorized Official

Name: DR. MUHAMMAD SALEEM AKHTAR
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 951-849-2526