Individual
NICHOLAS JOHN PHREANER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(800) 926-8273
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A126789
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05350261
—
MS
05
—
2393375
—
LA
Enumeration date
07/05/2012
Last updated
06/17/2019
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