# BAMBI L NICKELBERRY MD PROFESSIONAL CORPORATION

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

## Provider details

- **NPI number:** 1972772655
- **Authorized official:** DR. BAMBI LYNN NICKELBERRY M.D. (DIRECTOR/OWNER)
- **Authorized official phone:** (310) 673-3737

## Contact information

- **Practice address:** 248 N LOCUST ST, INGLEWOOD, CA 90301-1258
- **Practice address phone:** (310) 673-3737
- **Practice address fax:** (310) 673-0248
- **Mailing address:** 248 N LOCUST ST, INGLEWOOD, CA 90301-1258
- **Mailing address phone:** (310) 673-3737
- **Mailing address fax:** (310) 673-0248

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | G466791 | CA | Yes |

## Other

- **Enumeration date:** 02/26/2008
- **Last updated:** 06/21/2022