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Contact Information

COLLEEN L CHANNICK, MD
1223 16TH ST STE 3400
SANTA MONICA, CA90404-1279
 Phone: 310-449-0939
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
 

Critical Care Medicine

207RC0200X 11 Physician/Internal Medicine
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for COLLEEN L CHANNICK · (Female)

NPI # 1023043775
Status Active
Credentials MD
Entity Individual
Enumeration date 07/11/2006
Last updated 07/05/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • CA License # A64140
  • CA Medicaid 00A641400
Hospital affiliation(s)
  • RONALD REAGAN UCLA MEDICAL CENTER - (Acute Care)
    757 WESTWOOD PLAZA
    LOS ANGELES, CA 90095
  • SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL - (Acute Care)
    1250 16TH STREET
    SANTA MONICA, CA 90404
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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