Individual
NICOLAS MAALOUF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
620 SHADOW LN, LAS VEGAS, NV 89106-4119
(702) 388-8436
Mailing address
501 S BUENA VISTA ST, BURBANK, CA 91505-4809
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20A23770
CA
208D00000X
General Practice Physician
SL1892
NV
390200000X
Student in an Organized Health Care Education/Training Program
SL1892
—
Other
Enumeration date
06/28/2022
Last updated
06/30/2025
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