Individual
DR. COLETTE H WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1330 STANFORD ST APT D, SANTA MONICA, CA 90404-2543
(310) 736-8999
Mailing address
1330 STANFORD ST APT D, SANTA MONICA, CA 90404-2543
(310) 736-8999
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A106115
CA
207R00000X
Internal Medicine Physician
A106115
CA
Other
Enumeration date
05/29/2007
Last updated
11/29/2021
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