Channick, Colleen Lucy

Channick, Colleen Lucy is an individual health care provider with primary practice located at 1223 16Th St Ste 3400 , Santa Monica CA 90404-1279. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is her primary health care specialty. Channick, Colleen Lucy can be contacted via phone (310) 449-0939.

Contact Information

Primary practice address
1223 16Th St Ste 3400 Santa Monica CA 90404-1279
Phone: (310) 449-0939
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X A64140 California
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X A64140 California
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X A64140 California

Profile Details

NPI number 1023043775
LBN Legal business name Channick, Colleen Lucy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2006
Last updated Jul 5th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023043775 NPPES
California MEDICAID 00A641400

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