Provider Demographics
NPI:1790998227
Name:COLEMAN, STEPHEN JAMES (LAC LICENSED ACUPUNC)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:JAMES
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:LAC LICENSED ACUPUNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 A 29TH STREET
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131-2304
Mailing Address - Country:US
Mailing Address - Phone:415-824-5993
Mailing Address - Fax:415-282-3773
Practice Address - Street 1:315 A 29TH STREET
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94131-2304
Practice Address - Country:US
Practice Address - Phone:415-824-5993
Practice Address - Fax:415-282-3773
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC2689171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist