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General NPI Number Information
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NPI Number | 1790456465
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Entity Type | Individual
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Provider Name | CARLOS COLON JR. MSN, NP-C
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Gender | Male
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Dates
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Enumeration Date | 09/23/2021
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Last Update Date | 11/15/2025
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Provider Practice Location Address
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Address Line | 35800 BOB HOPE DR STE 255
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-1786
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Country | US
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Telephone | 951-773-3379
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 35380
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City | LAS VEGAS
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State | NV
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Zip | 89133-5380
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Country | US
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Telephone | 702-579-3203
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 95018505
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 95018505
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 95018505
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License Number State | CA
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