Dacosta Alonzo Collymore, RPT | |
5000 Overland Ave Ste 4, Culver City, CA 90230-4995 | |
(310) 836-7650 | |
(310) 836-7651 |
Full Name | Dacosta Alonzo Collymore |
---|---|
Gender | Male |
Speciality | Physical Therapy |
Experience | 30 Years |
Location | 5000 Overland Ave Ste 4, Culver City, California |
Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568497659 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 20709 (California) | Primary |
Provider Name | Dacosta Collymore |
---|---|
Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1609058445 PECOS PAC ID: 9133185861 Enrollment ID: O20041204000273 |
Mailing Address | Practice Location Address |
---|---|
Dacosta Alonzo Collymore, RPT 5000 Overland Ave Ste 4, Culver City, CA 90230-4995 Ph: (310) 836-7650 | Dacosta Alonzo Collymore, RPT 5000 Overland Ave Ste 4, Culver City, CA 90230-4995 Ph: (310) 836-7650 |
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