Organization
BAMBI L NICKELBERRY MD PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BAMBI LYNN NICKELBERRY M.D. (DIRECTOR/OWNER)
(310) 673-3737
Entity
Organization
Contact information
Practice address
248 N LOCUST ST, INGLEWOOD, CA 90301-1258
(310) 673-3737
(310) 673-0248
Mailing address
248 N LOCUST ST, INGLEWOOD, CA 90301-1258
(310) 673-3737
(310) 673-0248
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
G466791
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G466791
—
CA
Enumeration date
02/26/2008
Last updated
06/21/2022
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