Individual
ALFRED COLEMAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
1644 ALUM ROCK AVE, SAN JOSE, CA 95116-2429
(408) 347-1680
(408) 347-1681
Mailing address
838 ANTERO CT, SAN JOSE, CA 95133-1202
(408) 347-1680
(408) 347-1681
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
PA10187
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA10187
PHYSICIAN ASSISTANT LICEN
CA
Enumeration date
10/02/2006
Last updated
07/08/2007
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