Provider Demographics
NPI:1578451431
Name:BAILEY, COLE
Entity type:Individual
Prefix:
First Name:COLE
Middle Name:
Last Name:BAILEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9146 PARADISE CT
Mailing Address - Street 2:
Mailing Address - City:DELHI
Mailing Address - State:CA
Mailing Address - Zip Code:95315-9386
Mailing Address - Country:US
Mailing Address - Phone:209-620-0342
Mailing Address - Fax:
Practice Address - Street 1:9146 PARADISE CT
Practice Address - Street 2:
Practice Address - City:DELHI
Practice Address - State:CA
Practice Address - Zip Code:95315-9386
Practice Address - Country:US
Practice Address - Phone:209-620-0342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer