1992146708 NPI number — DR. KERI MICHELLE COLIO AUD

Table of content: DR. KERI MICHELLE COLIO AUD (NPI 1992146708)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992146708 NPI number — DR. KERI MICHELLE COLIO AUD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COLIO
Provider First Name:
KERI
Provider Middle Name:
MICHELLE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
AUD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COLE
Provider Other First Name:
KERI
Provider Other Middle Name:
MICHELLE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
AUD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1992146708
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/09/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3020 CHILDREN'S WAY, MC 5010
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN DIEGO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92123
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
858-966-1700
Provider Business Mailing Address Fax Number:
858-966-7803

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3665 KEARNY VILLA ROAD
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-966-1700
Provider Business Practice Location Address Fax Number:
858-966-7803
Provider Enumeration Date:
07/09/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  2942 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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