MEDICARE: KATHERINE COLLIER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	41593	CA

General Provider Information

NPI Number	:	1902278054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE COLLIER

Provider Business Mailing Address
First Line	:	5822 S VERMONT AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90044-3712
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5822 S VERMONT AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90044-3712
Country	:	US
Telephone Number	:	323-750-5222
Fax Number	:	323-750-1245

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2015
Last Update Date	:	10/28/2015

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Directions to “ KATHERINE COLLIER ” Practice Location

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