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General NPI Number Information
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NPI Number | 1235580986
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Entity Type | Individual
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Provider Name | MR. NICHOLAS COLE
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Gender | Male
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Dates
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Enumeration Date | 06/23/2016
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 2020 COURT ST
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City | REDDING
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State | CA
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Zip | 96001-1822
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Country | US
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Telephone | 530-243-1249
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Fax | 530-243-3544
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Provider Business Mailing Address
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Address Line | 3400 DATA DR ATTENTION: CREDENTIALING AND PAYER ENROLLMENT DEPT
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City | RANCHO CORDOVA
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State | CA
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Zip | 95670
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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