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Individual

JOHN M CORMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
100 W CALIFORNIA BLVD, PASADENA, CA 91105-3010
(626) 397-3737
Mailing address
1100 OLIVE WAY MSC M4-PA, SEATTLE, WA 98101-1873
(206) 515-5811

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD00036063
WA
208800000X
Urology Physician
Primary
A52939
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0039595
LABOR & INDUSTRY
WA
01
7651CO
BLUE SHIELD
WA
01
806259200
IDAHO MEDICAID
WA
05
8249047
WA
01
MD9975W
ALASKA MEDICAID
WA
01
US7918102
AETNA/USHC SPECIALIST
WA
Enumeration date
07/10/2006
Last updated
12/22/2023
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