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Individual

RICHARD T NICHOLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2100 LYNN RD, #250, THOUSAND OAKS, CA 91360
(805) 493-2331
Mailing address
2674 CALLE PERA, THOUSAND OAKS, CA 91360-6632
(805) 493-2331

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
G19630
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G196301
CA
Enumeration date
05/16/2006
Last updated
11/21/2007
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