# NICOLA MEDICAL CENTER

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

## Provider details

- **NPI number:** 1841035615
- **Authorized official:** DR. NICHOLAS NICK DZEBOLO MD (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (323) 274-4710

## Contact information

- **Practice address:** 1718 COLORADO BLVD STE A, LOS ANGELES, CA 90041-1338
- **Practice address phone:** (323) 274-4710
- **Practice address fax:** (323) 274-4709
- **Mailing address:** 1718 COLORADO BLVD STE A, LOS ANGELES, CA 90041-1338
- **Mailing address phone:** (323) 274-4710
- **Mailing address fax:** (323) 274-4709

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/25/2024
- **Last updated:** 06/25/2024