Provider Demographics
NPI:1164233474
Name:CALLOWAY, COLIN DEAN (BA)
Entity type:Individual
Prefix:
First Name:COLIN
Middle Name:DEAN
Last Name:CALLOWAY
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2847 MONARCH ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-3239
Mailing Address - Country:US
Mailing Address - Phone:818-515-6029
Mailing Address - Fax:
Practice Address - Street 1:44349 LOWTREE AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4100
Practice Address - Country:US
Practice Address - Phone:661-228-0567
Practice Address - Fax:205-509-5377
Is Sole Proprietor?:No
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator