=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174452221
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE GERIATRICIAN PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/15/2026
-----------------------------------------------------
Last Update Date | 05/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9100 WILSHIRE BLVD EAST TOWER SUITE 333 - #2037
-----------------------------------------------------
City | BEVERLY HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90212
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 424-209-7881
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9100 WILSHIRE BLVD EAST TOWER SUITE 333 - #2037
-----------------------------------------------------
City | BEVERLY HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90212
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 424-209-7881
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | KARLA MARTINEZ COLEMAN
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 512-524-7676
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0300X
-----------------------------------------------------
Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------