Provider Demographics
NPI:1164608659
Name:COLIN, CAROLINE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:MARIE
Last Name:COLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2021 SANTA MONICA BLVD
Mailing Address - Street 2:SUITE 304E
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2208
Mailing Address - Country:US
Mailing Address - Phone:310-829-0080
Mailing Address - Fax:310-829-0090
Practice Address - Street 1:2021 SANTA MONICA BLVD
Practice Address - Street 2:SUITE 304E
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2208
Practice Address - Country:US
Practice Address - Phone:310-829-0080
Practice Address - Fax:310-829-0090
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD037068207V00000X
CAA91499207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology