Individual
COLLEEN LINDA COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
510 SUPERIOR AVE, SUITE 200-G, NEWPORT BEACH, CA 92663-3663
(949) 791-6767
(949) 791-6768
Mailing address
510 SUPERIOR AVE, SUITE 200G, NEWPORT BEACH, CA 92663-3663
(949) 791-6767
(949) 791-6768
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G080909
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10946255
CAQH PROVIDER ID
CA
Enumeration date
06/13/2006
Last updated
04/16/2015
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