Provider Demographics
NPI:1720052780
Name:COLLINS, JAMES JR (ATC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:COLLINS
Suffix:JR
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11318 LUXEMBOURG WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-2939
Mailing Address - Country:US
Mailing Address - Phone:858-874-4500
Mailing Address - Fax:
Practice Address - Street 1:4020 MURPHY CANYON RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4407
Practice Address - Country:US
Practice Address - Phone:858-874-4503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer