Organization
NICODEMUS MEDICAL CORPORATION
Active
Other names
Advanced Osteopathy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLARENCE LYN NICODEMUS D.O. PHD. (PRESIDENT, MEDICAL DIRECTOR)
(831) 644-9614
Entity
Organization
Contact information
Practice address
910 MAJOR SHERMAN LN, SUITE 300, MONTEREY, CA 93940-4642
(831) 664-9614
(831) 644-9615
Mailing address
910 MAJOR SHERMAN LN, SUITE 300, MONTEREY, CA 93940-4642
(831) 664-9614
(831) 644-9615
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
20A10296
CA
Other
Enumeration date
05/21/2014
Last updated
01/14/2015
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