Healthcare Provider Details

I. General information

NPI: 1811297179
Provider Name (Legal Business Name): JOHN P COLMAN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2010
Last Update Date: 11/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 POLLARD RD STE A2
LOS GATOS CA
95032-1432
US

IV. Provider business mailing address

800 POLLARD RD STE A2
LOS GATOS CA
95032-1432
US

V. Phone/Fax

Practice location:
  • Phone: 408-379-3311
  • Fax: 408-364-8070
Mailing address:
  • Phone: 408-379-3311
  • Fax: 408-364-8070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberA25540
License Number StateCA

VIII. Authorized Official

Name: DR. JOHN P COLMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 408-379-3311