Individual
DR. NICKOLAY T. TEOPHILOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
222 W EULALIA ST, SUITE 301, GLENDALE, CA 91204-2849
(310) 472-0171
(310) 472-0171
Mailing address
2385 ROSCOMARE RD, B-8, LOS ANGELES, CA 90077-1838
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
A55038
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A550380
—
CA
Enumeration date
11/10/2006
Last updated
06/04/2008
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