Healthcare Provider Details

I. General information

NPI: 1033350764
Provider Name (Legal Business Name): MS. YOLANDA J COLLINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2009
Last Update Date: 03/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6124 S NORMANDIE AVE
LOS ANGELES CA
90044-2724
US

IV. Provider business mailing address

6124 S NORMANDIE AVE
LOS ANGELES CA
90044-2724
US

V. Phone/Fax

Practice location:
  • Phone: 213-308-9757
  • Fax:
Mailing address:
  • Phone: 213-308-9757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: