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Organization
NICODEMUS MEDICAL CORPORATION
Active
Organization
NICODEMUS MEDICAL CORPORATION
Active
Other names
Advanced Osteopathy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLARENCE LYN NICODEMUS D.O. PHD. (PRESIDENT, MEDICAL DIRECTOR)
(831) 644-9614
Entity
Organization
Contact information
Practice address
910 MAJOR SHERMAN LN, SUITE 300, MONTEREY, CA 93940-4642
(831) 664-9614
(831) 644-9615
Mailing address
910 MAJOR SHERMAN LN, SUITE 300, MONTEREY, CA 93940-4642
(831) 664-9614
(831) 644-9615
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
20A10296
CA
Other
Enumeration date
05/21/2014
Last updated
01/14/2015
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