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General NPI Number Information
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NPI Number | 1811399645
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Entity Type | Individual
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Provider Name | PATRICK JOHN COFFEY PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/24/2014
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 14011 PARK AVE
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City | VICTORVILLE
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State | CA
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Zip | 92392-2413
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Country | US
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Telephone | 951-788-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 16840 CANYON VIEW DR
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City | RIVERSIDE
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State | CA
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Zip | 92504-6252
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Country | US
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Telephone | 951-733-9979
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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 |
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License Number State | CA
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