# AIRELL L NYGAARD MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609062132
- **Authorized official:** DR. AIRELL L NYGAARD MD (PRESIDENT & SOLE OWNER)
- **Authorized official phone:** (209) 588-1800

## Contact information

- **Practice address:** 680 GUZZI LN, SUITE 102, SONORA, CA 95370-5288
- **Practice address phone:** (209) 588-1800
- **Practice address fax:** (209) 588-1700
- **Mailing address:** 680 GUZZI LN, SUITE 102, SONORA, CA 95370-5288
- **Mailing address phone:** (209) 588-1800
- **Mailing address fax:** (209) 588-1700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA18044 | CA | Yes |

## Other

- **Enumeration date:** 09/19/2007
- **Last updated:** 05/20/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00C374790 | — | CA |