Individual
ELIAS NICOLAS KIWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1020 29TH STREET, SUITE 680, SACRAMENTO, CA 95816-5124
(916) 453-3300
(916) 453-3313
Mailing address
10470 OLD PLACERVILLE RD, SUITE 100, SACRAMENTO, CA 95827-2539
(800) 470-0071
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
E-3479
AR
207RH0003X
Hematology & Oncology Physician
Primary
C54469
CA
208M00000X
Hospitalist Physician
E-3479
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150033001
—
AR
Enumeration date
10/13/2006
Last updated
08/17/2015
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