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General NPI Number Information
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NPI Number | 1497049290
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Entity Type | Organization
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Legal Business Name | BRYNIE SLOME COLLINS MD, INC
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Dates
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Enumeration Date | 06/09/2011
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Last Update Date | 06/09/2011
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Provider Practice Location Address
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Address Line | 5363 BALBOA BLVD. SUITE 540
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City | ENCINO
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State | CA
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Zip | 91316-2805
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Country | US
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Telephone | 818-905-6600
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Fax |
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Provider Business Mailing Address
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Address Line | 5363 BALBOA BLVD. SUITE 540
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City | ENCINO
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State | CA
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Zip | 91316-2805
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Country | US
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Telephone | 818-905-6600
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRYNIE S COLLINS
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Credential | MD
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Telephone | 818-905-6600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | A80600
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License Number State | CA
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