# NATHAN RHEAULT DO PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174390900
- **Authorized official:** DR. NATHAN RHEAULT DO (PHYSICIAN OWNER)
- **Authorized official phone:** (831) 419-6446

## Contact information

- **Practice address:** 740 FRONT ST STE 345B, SANTA CRUZ, CA 95060-4561
- **Practice address phone:** (831) 419-6446
- **Practice address fax:** (949) 561-5836
- **Mailing address:** 740 FRONT ST STE 345B, SANTA CRUZ, CA 95060-4561
- **Mailing address phone:** (831) 419-6446
- **Mailing address fax:** (949) 561-5836

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 12/12/2023
- **Last updated:** 12/12/2023