Provider Demographics
NPI:1104136431
Name:ALAN J. COLEMAN, M.D.: A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:ALAN J. COLEMAN, M.D.: A PROFESSIONAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ALAN J. COLEMAN PROF CORP
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:JULIAN
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-929-0660
Mailing Address - Street 1:2299 POST STREET
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3473
Mailing Address - Country:US
Mailing Address - Phone:415-929-0660
Mailing Address - Fax:415-931-0263
Practice Address - Street 1:2299 POST STREET
Practice Address - Street 2:SUITE 203
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3473
Practice Address - Country:US
Practice Address - Phone:415-929-0660
Practice Address - Fax:415-931-0263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG6782207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A57617Medicare UPIN