Healthcare Provider Details

I. General information

NPI: 1386457042
Provider Name (Legal Business Name): COLOR MEDICAL KANSAS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2025
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 OYSTER POINT BLVD STE 300-3B
SOUTH SAN FRANCISCO CA
94080-1974
US

IV. Provider business mailing address

365 OYSTER POINT BLVD STE 300-3B
SOUTH SAN FRANCISCO CA
94080-1974
US

V. Phone/Fax

Practice location:
  • Phone: 844-352-6567
  • Fax: 650-396-3046
Mailing address:
  • Phone: 844-352-6567
  • Fax: 650-396-3046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. RONALD DIXON
Title or Position: CEO
Credential: M.D.
Phone: 617-312-6914