Individual
CARRIE J. NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 MERCY CIRCLE, FAMILY MEDICINE DEPT, CAMP PENDLETON, CA 92058
(760) 719-3616
(760) 725-1101
Mailing address
200 MERCY CIRCLE, FAMILY MEDICINE DEPT, CAMP PENDLETON, CA 92058
(760) 719-3616
(760) 725-1101
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
A83442
CA
207Q00000X
Family Medicine Physician
Primary
A83442
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A834420
—
CA
01
—
A83442
MEDICAL LICENSE
CA
Enumeration date
05/17/2006
Last updated
02/07/2025
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