Individual
NICHOLAS KUSNEZOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5643 COPLEY DR STE 300, SAN DIEGO, CA 92111-7903
(858) 455-9942
(858) 455-6473
Mailing address
5643 COPLEY DR STE 300, SAN DIEGO, CA 92111-7903
(858) 455-9942
(858) 455-6473
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
036147531
IL
207X00000X
Orthopaedic Surgery Physician
51891
KY
207X00000X
Orthopaedic Surgery Physician
58084
AZ
207X00000X
Orthopaedic Surgery Physician
Primary
A155908
CA
Other
Enumeration date
06/26/2013
Last updated
05/02/2025
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