Healthcare Provider Details

I. General information

NPI: 1609922178
Provider Name (Legal Business Name): MARC F. COLMAN, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 06/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 LOMITA BLVD SUITE 203
TORRANCE CA
90505-5019
US

IV. Provider business mailing address

3500 LOMITA BLVD SUITE 203
TORRANCE CA
90505-5021
US

V. Phone/Fax

Practice location:
  • Phone: 310-373-6039
  • Fax: 310-326-5514
Mailing address:
  • Phone: 310-373-6039
  • Fax: 310-326-5514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: DEANNA JUAREZ
Title or Position: OFFICE MANAGER
Credential:
Phone: 310-373-6039