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Individual
GARY NICHOLS
Active
Individual
GARY NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G73872
CA
207RH0000X
Hematology (Internal Medicine) Physician
181851
CA
207RH0003X
Hematology & Oncology Physician
181851
CA
207RX0202X
Medical Oncology Physician
181851
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP059Z
PTAN
—
01
—
G73872
STATE MEDICAL LICENSE
CA
Enumeration date
09/29/2006
Last updated
07/10/2019
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