Provider Demographics
NPI:1538977764
Name:COLELLA, GIOVANNI MATTEO (MD)
Entity type:Individual
Prefix:
First Name:GIOVANNI
Middle Name:MATTEO
Last Name:COLELLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:706 MISSION ST APT 14B
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-3162
Mailing Address - Country:US
Mailing Address - Phone:415-519-5814
Mailing Address - Fax:
Practice Address - Street 1:706 MISSION ST APT 14B
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-3162
Practice Address - Country:US
Practice Address - Phone:415-519-5814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA481602084B0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & Neuropsychiatry