Organization
JAMES R. NICKEL, M.D., INC
Active
Other names
Pathology Associates of Southern California
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES R. NICKEL M.D. (OWNER / DIRECTOR)
(619) 757-4211
Entity
Organization
Contact information
Practice address
9355 CHAPMAN AVE., SUITE 102, GARDEN GROVE, CA 92841-4306
(619) 757-4211
(619) 226-2805
Mailing address
9355 CHAPMAN AVE., SUITE 102, GARDEN GROVE, CA 92841-4306
(619) 757-4211
(619) 226-2805
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF11502
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB51370F
—
CA
Enumeration date
12/14/2006
Last updated
03/26/2013
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