MEDICARE: JULIUS COLEMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	372600000X	Adult Companion
2	172V00000X	Community Health Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	91745998A	OTHER	CA	MEDICAL

General Provider Information

NPI Number	:	1114634250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIUS COLEMAN

Provider Business Mailing Address
First Line	:	3815 MARCONI AVE
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95821-3867
Country	:	US
Telephone Number	:	916-890-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3815 MARCONI AVE
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95821-3867
Country	:	US
Telephone Number	:	916-890-3000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2022
Last Update Date	:	03/10/2026

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Directions to “ JULIUS COLEMAN ” Practice Location

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