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Organization
FREDERIC G NICOLA, MD, A PROFESSIONAL CORPORATION
Active
Organization
FREDERIC G NICOLA, MD, A PROFESSIONAL CORPORATION
Active
Parent organization
FREDERIC G NICOLA, MD, A PROFESSIONAL CORPORATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
FREDERIC G NICOLA, MD, A PROFESSIONAL CORPORATION
Authorized official
FREDERIC NICOLA MD (PRESIDENT)
(310) 574-0487
Entity
Organization
Contact information
Practice address
13160 MINDANAO WAY, STE 300, MARINA DEL REY, CA 90292-6358
(310) 574-0487
Mailing address
2980 N BEVERLY GLEN CIR, STE 301, LOS ANGELES, CA 90077-1726
(310) 474-9809
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
NULL
Other
Enumeration date
02/25/2011
Last updated
02/25/2011
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