Organization
STEPHEN P. NICHOLS, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN P. NICHOLS M.D. (PRESIDENT)
(760) 633-3130
Entity
Organization
Contact information
Practice address
351 SANTA FE DR STE 100, ENCINITAS, CA 92024-5137
(760) 633-3130
(760) 633-3546
Mailing address
351 SANTA FE DR STE 100, ENCINITAS, CA 92024-5137
(760) 633-3130
(760) 633-3546
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G57814
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G578140
BLUE SHIELD
—
Enumeration date
02/22/2007
Last updated
02/01/2009
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