Individual
CHAD COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPA, PA-C
Contact information
Practice address
25455 BARTON RD STE 204B, LOMA LINDA, CA 92354
(909) 558-6600
Mailing address
FILE #54701, LOS ANGELES, CA 90074-4701
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
56182
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA56182
PHYSICIAN ASSISTANT BOARD, THE MEDICAL BOARD OF CALIFORNIA
CA
Enumeration date
08/12/2018
Last updated
12/17/2019
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