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Individual

DR. JOHN RAYMOND COLEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AU.D.

Contact information

Practice address
26726 CROWN VALLEY PKWY, SUITE 210, MISSION VIEJO, CA 92691-6364
(949) 364-4361
(949) 364-7124
Mailing address
26726 CROWN VALLEY PKWY, SUITE 210, MISSION VIEJO, CA 92691-6364
(949) 364-4361
(949) 364-7124

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AU683
CA
237700000X
Hearing Instrument Specialist
HA1691
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AM896Y
PTAN
CA
01
AM896Z
INDIVIDUAL PTAN
CA
01
AU0006830
MEDI-CAL #
CA
01
AU683
STATE AUDIOLOGY LICENSE
CA
01
HA 1691
HEARING AID DISPENSING
CA
01
W15940
GROUP PTAN
CA
01
W8109
GROUP PTAN
CA
Enumeration date
08/03/2005
Last updated
02/04/2009
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