Collom, Karen S
Collom, Karen S is an sole proprietor health care provider with primary practice located at 3162 Campus Dr , San Mateo CA 94403-3123. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Collom, Karen S can be contacted via phone (650) 345-0248.Contact Information
Primary practice address
3162 Campus Dr
San Mateo CA 94403-3123
Phone: (650) 345-0248
Fax: (650) 345-7313
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 10267T | California |
Profile Details
| NPI number | 1104887629 |
|---|---|
| LBN Legal business name | Collom, Karen S |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 1st, 2006 |
| Last updated | Mar 7th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104887629 | NPPES |
| California | Other | SD012670 | PTAN |
| California | Other | 1104887629 | PTAN |
| California | MEDICAID | SD0102670 | PTAN |
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