Organization
COLETTE WISEMAN, MD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. COLETTE WISEMAN MD (PRESIDENT)
(424) 234-6461
Entity
Organization
Contact information
Practice address
744 N KENTER AVE, LOS ANGELES, CA 90049-5105
(424) 234-6461
Mailing address
11693 SAN VICENTE BLVD # 445, LOS ANGELES, CA 90049-5105
(424) 234-6461
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
—
—
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
08/22/2025
Last updated
08/22/2025
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