MEDICARE: MICHAEL W. COLBURN DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	E2942	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174601264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL W. COLBURN DPM

Provider Business Mailing Address
First Line	:	1050 MURRIETA BLVD
Second Line	:
City	:	LIVERMORE
State	:	CA
Zip	:	94550-4111
Country	:	US
Telephone Number	:	925-455-1555
Fax Number	:	925-292-7592

Provider Business Practice Location Address
First Line	:	911 MORAGA RD STE 101
Second Line	:
City	:	LAFAYETTE
State	:	CA
Zip	:	94549-4591
Country	:	US
Telephone Number	:	925-962-9120
Fax Number	:	925-962-9122

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	01/11/2026

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