Organization
COLE MD MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DYAN COLE M.D. (PRESIDENT/CEO)
(818) 854-4400
Entity
Organization
Contact information
Practice address
22203 SHERMAN WAY, CANOGA PARK, CA 91303-1048
(818) 854-4400
Mailing address
22203 SHERMAN WAY, CANOGA PARK, CA 91303-1048
(818) 854-4400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G67490
CA
Other
Enumeration date
11/12/2015
Last updated
11/12/2015
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