Provider Demographics
NPI:1407920002
Name:COLLINS, MICHAEL H (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:H
Last Name:COLLINS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 S HARBOR BLVD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-3733
Mailing Address - Country:US
Mailing Address - Phone:714-978-7488
Mailing Address - Fax:714-922-1014
Practice Address - Street 1:300 S HARBOR BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-3733
Practice Address - Country:US
Practice Address - Phone:714-978-7488
Practice Address - Fax:714-922-1014
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2010-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A81952083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
020A81950Medicare ID - Type Unspecified