Individual
DR. NICHOLAS SHIZUO THALER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
760 WESTWOOD PLZ, LOS ANGELES, CA 90095-1759
(310) 570-5113
(310) 301-8751
Mailing address
5767 W CENTURY BLVD, SUITE 400, LOS ANGELES, CA 90045-5631
(310) 206-8100
(310) 301-8751
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
27149
CA
Other
Enumeration date
05/29/2015
Last updated
12/15/2015
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