Organization
JOHN R COLEMAN MD INC
Active
Organization
JOHN R COLEMAN MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN RANDALL COLEMAN M.D. (PRESIDENT)
(626) 473-1032
Entity
Organization
Contact information
Practice address
12401 WASHINGTON BLVD, WHITTIER, CA 90602-1006
(562) 698-0811
Mailing address
PO BOX 3098, TORRANCE, CA 90510-3098
(310) 792-3914
(855) 898-4055
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C339600
BLUE SHIELD
CA
05
—
00C339601
—
CA
Enumeration date
08/05/2006
Last updated
12/17/2013
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