Provider Demographics
NPI:1548274947
Name:COLMAN, MARC F (MD)
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:F
Last Name:COLMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG31900207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A44908Medicare UPIN