Provider Demographics
NPI:1992594642
Name:RANSAW, COLEY T (PA-S)
Entity type:Individual
Prefix:
First Name:COLEY
Middle Name:T
Last Name:RANSAW
Suffix:
Gender:
Credentials:PA-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 N MAIN PLACE DR UNIT 416
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-6062
Mailing Address - Country:US
Mailing Address - Phone:504-915-9444
Mailing Address - Fax:
Practice Address - Street 1:2727 N MAIN PLACE DR UNIT 416
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-6062
Practice Address - Country:US
Practice Address - Phone:504-915-9444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program