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General NPI Number Information
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NPI Number | 1124820048
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Entity Type | Individual
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Provider Name | JAMIE COLES PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/24/2025
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 23441 MADISON ST STE 301
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City | TORRANCE
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State | CA
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Zip | 90505-4735
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Country | US
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Telephone | 310-953-0020
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Fax |
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Provider Business Mailing Address
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Address Line | 9401 JERONIMO RD
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City | IRVINE
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State | CA
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Zip | 92618-1908
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1230905
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License Number State | CA
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