Provider Demographics
NPI:1053829879
Name:PROTOCOL INTELLIGENCE INC.
Entity Type:Organization
Organization Name:PROTOCOL INTELLIGENCE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:COLBORN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:760-497-9718
Mailing Address - Street 1:3210 MERRYFIELD ROW
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-1126
Mailing Address - Country:US
Mailing Address - Phone:858-242-1560
Mailing Address - Fax:
Practice Address - Street 1:3210 MERRYFIELD ROW
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1126
Practice Address - Country:US
Practice Address - Phone:858-242-1560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-15
Last Update Date:2018-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1100XAmbulatory Health Care FacilitiesClinic/CenterResearch