Healthcare Provider Details
I. General information
NPI: 1174452221
Provider Name (Legal Business Name): THE GERIATRICIAN PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/15/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9100 WILSHIRE BLVD EAST TOWER SUITE 333 - #2037
BEVERLY HILLS CA
90212
US
IV. Provider business mailing address
9100 WILSHIRE BLVD EAST TOWER SUITE 333 - #2037
BEVERLY HILLS CA
90212
US
V. Phone/Fax
- Phone: 424-209-7881
- Fax:
- Phone: 424-209-7881
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0300X |
| Taxonomy | Geriatric Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KARLA
MARTINEZ COLEMAN
Title or Position: CEO
Credential: MD
Phone: 512-524-7676