Individual
ANDREW J. NICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 TRANCAS STREET, NAPA, CA 94558-2906
(707) 252-4411
(707) 252-2240
Mailing address
PO BOX 348120, SACRAMENTO, CA 95834
(707) 252-4633
(707) 252-2240
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G24715
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G247150
—
CA
Enumeration date
02/24/2006
Last updated
06/17/2008
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