Individual
MR. BROCK VICTOR NYQUIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.R.N.A., MSN
Contact information
Practice address
902 N GRAND AVE, SANTA ANA, CA 92701-4218
(562) 544-8804
Mailing address
5701 E 2ND ST, #8, LONG BEACH, CA 90803-5072
(562) 439-1609
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3079
CA
367500000X
Certified Registered Nurse Anesthetist
489087
CA
Other
Enumeration date
10/12/2006
Last updated
10/01/2010
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