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General NPI Number Information
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NPI Number | 1538273008
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Entity Type | Individual
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Provider Name | KENNETH F COLINA MD
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Gender | Male
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 05/30/2018
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Provider Practice Location Address
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Address Line | 3020 CHILDRENS WAY
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City | SAN DIEGO
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State | CA
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Zip | 92123
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Country | US
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Telephone | 858-966-5841
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Fax |
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Provider Business Mailing Address
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Address Line | 3020 CHILDRENS WAY # MC5064
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City | SAN DIEGO
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State | CA
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Zip | 92123-4223
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Country | US
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Telephone | 858-966-5841
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | J3298
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | J3298
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 153469
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License Number State | CA
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