Individual
DR. NICHOLAS N NISSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
127 S SAN VICENTE BLVD FL 7, LOS ANGELES, CA 90048-3311
(310) 423-6746
(310) 423-7596
Mailing address
4140 W 190TH ST, TORRANCE, CA 90504-5513
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
G85301
CA
208600000X
Surgery Physician
G85301
CA
2086S0102X
Surgical Critical Care Physician
Primary
G85301
CA
Other
Enumeration date
12/05/2005
Last updated
08/15/2025
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