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General NPI Number Information
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NPI Number | 1306465067
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Entity Type | Individual
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Provider Name | NICOLAUS ADRIANUS COLEMAN
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Gender | Male
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Dates
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Enumeration Date | 04/13/2020
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 400 DUMAS CT
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City | ROSEVILLE
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State | CA
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Zip | 95747-5812
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Country | US
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Telephone | 530-601-9550
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Fax |
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Provider Business Mailing Address
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Address Line | 1730 PALMER DR
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City | TURLOCK
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State | CA
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Zip | 95382-2892
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Country | US
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Telephone | 209-985-5733
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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 | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number | A195583
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License Number State | CA
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