NPIMap

Organization Active NPI

Colette Wiseman, MD, Inc

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1871471490
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
COLETTE WISEMAN, MD, INC
Practice address
744 N Kenter Ave
Los Angeles, CA 90049-5105
Phone
(424) 234-6461
NPI assigned
Aug 22, 2025
Last updated
Aug 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Colette Wiseman, MDNPI 1104027150
Title
President
Phone
(424) 234-6461

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN)Group: 193200000X MULTI-SPECIALTY GROUP 174N00000X
Emergency Medical Services (Emergency Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207PE0004X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

744 N Kenter Ave
Los Angeles, CA 90049-5105

Mailing address

11693 San Vicente Blvd # 445
Los Angeles, CA 90049-5105
Phone (424) 234-6461

National Provider Directory

National Provider Directory

Locations

11693 San Vicente Blvd
Los Angeles, CA 90049
Phone (310) 388-7949

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1755820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755820800000",
    "number": "1871471490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11693 SAN VICENTE BLVD # 445",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495105",
            "telephone_number": "424-234-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 N KENTER AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495105",
            "telephone_number": "424-234-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLETTE WISEMAN, MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-22",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-16",
        "status": "A",
        "authorized_official_last_name": "WISEMAN",
        "authorized_official_first_name": "COLETTE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "424-234-6461",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.