Individual
COLE LANDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
Primary
1467795161
CA
261QU0200X
Urgent Care Clinic/Center
PA-2091
ID
Other
Enumeration date
07/02/2019
Last updated
05/05/2022
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