Individual
NATHAN JACK NELLESSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11234 ANDERSON ST, LOMA LINDA, CA 92354-2804
(909) 558-6491
Mailing address
11234 ANDERSON ST, LOMA LINDA, CA 92354-2804
(909) 558-6491
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
A180188
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Enumeration date
04/02/2021
Last updated
07/20/2023
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