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Individual

DR. DEREK WALTER NICKERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5550 CARMEL MOUNTAIN RD, SAN DIEGO, CA 92130-4853
(858) 943-2540
Mailing address
5550 CARMEL MOUNTAIN RD, SAN DIEGO, CA 92130-4853
(858) 943-2540

Taxonomy

Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
A171167
CA

Other

Enumeration date
04/02/2016
Last updated
05/18/2025
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