Provider Demographics
NPI:1174764914
Name:MARC F COLMAN MD PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:MARC F COLMAN MD PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:F
Authorized Official - Last Name:COLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-373-6039
Mailing Address - Street 1:3440 LOMITA BLVD
Mailing Address - Street 2:SUITE 252
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4801
Mailing Address - Country:US
Mailing Address - Phone:310-373-6039
Mailing Address - Fax:310-326-5514
Practice Address - Street 1:3440 LOMITA BLVD
Practice Address - Street 2:SUITE 252
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4801
Practice Address - Country:US
Practice Address - Phone:310-373-6039
Practice Address - Fax:310-326-5514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-06
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG31900207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty