Basic Information
Provider Information
NPI: 1396904736
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COLLINS
FirstName: AARON
MiddleName: CHRISTOPHER-DRAIN
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2050 S BLOSSER RD
Address2:  
City: SANTA MARIA
State: CA
PostalCode: 934587310
CountryCode: US
TelephoneNumber: 8053618028
FaxNumber: 8053618097
Practice Location
Address1: 416 SPRING ST
Address2: SUITE 201
City: PASO ROBLES
State: CA
PostalCode: 934463161
CountryCode: US
TelephoneNumber: 8052387250
FaxNumber: 8052380165
Other Information
ProviderEnumerationDate: 06/02/2008
LastUpdateDate: 04/22/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XTL-2827COY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


Home