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NPI Code Detail

MEDICARE: NATHAN JOHN COLEMAN

MEDICARE: NATHAN JOHN COLEMAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior AnalystLBA0304MN

General Provider Information

NPI Number : 1235808841
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHAN JOHN COLEMAN
Provider Business Mailing Address
First Line : 100 N PACIFIC COAST HWY STE 1400
Second Line :
City : EL SEGUNDO
State : CA
Zip : 90245-5602
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 13601 80TH CIR N STE 200
Second Line :
City : MAPLE GROVE
State : MN
Zip : 55369-9801
Country : US
Telephone Number : 763-272-5877
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2021
Last Update Date : 04/08/2025

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Directions to “ NATHAN JOHN COLEMAN ” Practice Location

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