Provider Demographics
NPI:1760762983
Name:TRUEBLOOD, NATHAN ANDREW (PHD, PA-C)
Entity Type:Individual
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First Name:NATHAN
Middle Name:ANDREW
Last Name:TRUEBLOOD
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Gender:M
Credentials:PHD, PA-C
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Mailing Address - Street 1:3300 DOUGLAS BLVD
Mailing Address - Street 2:SUITE 405
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3844
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6501 COYLE AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-0306
Practice Address - Country:US
Practice Address - Phone:916-537-5210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA21742363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant