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Organization

NICHOLAS J BEVILACQUA D P M INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. NICHOLAS J BEVILACQUA D.P.M. (OWNER)
(818) 902-5755
Entity
Organization

Contact information

Practice address
15107 VANOWEN ST, VAN NUYS, CA 91405-4542
(818) 902-5755
(818) 902-5766
Mailing address
15107 VANOWEN ST, VAN NUYS, CA 91405-4542
(818) 902-5755
(818) 902-5766

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4859
CA

Other

Enumeration date
12/29/2009
Last updated
05/24/2010
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