COLONIAL CORNER MEDICAL GROUP, INC.
NPI 1669596557
Specialist in San Diego, CA

Q: What is Colonial Corner Medical Group, Inc.'s NPI number?

The NPI number for Colonial Corner Medical Group, Inc. is 1669596557. It was assigned to this organization in the NPPES registry on March 18, 2007.

Q: What is Colonial Corner Medical Group, Inc.'s specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Active since March 18, 2007

4440 EUCLID AVE # C, SAN DIEGO, CA 92115(619) 582-5105(619) 582-5121 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 21, 2022, Sep 27, 2019 (2 updates tracked since 2019).

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About Colonial Corner Medical Group, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COLONIAL CORNER MEDICAL GROUP, INC. (NPI 1669596557) is a healthcare organization registered as a specialist in San Diego, California and active in the NPI registry since March 2007. The organization lists Elizabeth David, Finance Manager, as its authorized official.

NPPES Registry Identity

NPI1669596557

Entity TypeOrganization

Primary Taxonomy174400000X

Legal Business NameCOLONIAL CORNER MEDICAL GROUP, INC.

Location Address4440 EUCLID AVE # CSan Diego, CA 92115-4522

Mailing Address4440 Euclid Ave # CSan Diego, CA 92115-4522 · (619) 582-5105 · Fax (619) 582-5121

Phone(619) 582-5105

Fax(619) 582-5121

Organization SubpartNo

Authorized OfficialElizabeth DavidFinance Manager · (619) 582-5105

Enumeration DateMarch 18, 2007

Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration

✔ NPI 1669596557 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in CA · G86752

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

4440 EUCLID AVE # C, San Diego, CA 92115

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Other Names 1

Other NameColonial Corner Medical Group, Inc.

Other Identifiers 2

OtherW17287CA · Ptan

OtherGR0094010CA · Medi-cal

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. NADINE ELAINE SIDRICK M.D.

General Practice

4440 EUCLID AVE # C
SAN DIEGO, CA 92115

San Diego County (619) 582-5105

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Colonial Corner Medical Group, Inc.'s NPI number?

The NPI number for Colonial Corner Medical Group, Inc. is 1669596557. It was assigned to this organization in the NPPES registry on March 18, 2007.

Where is Colonial Corner Medical Group, Inc. located?

Colonial Corner Medical Group, Inc. is located at 4440 Euclid Ave # C, San Diego, CA 92115. The listed phone number is (619) 582-5105.

What is Colonial Corner Medical Group, Inc.'s specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Colonial Corner Medical Group, Inc. was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.