FREDERIC G NICOLA, MD, A PROFESSIONAL CORPORATION (NPI# 1417254459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417254459 |
| Entity Type | Organization |
| Organization Name | FREDERIC G NICOLA, MD, A PROFESSIONAL CORPORATION |
| Practice Address |
13160 Mindanao Way Ste 300 Marina Del Rey CA 90292-6358 |
| Mailing Address |
2980 N Beverly Glen Cir Ste 301 Los Angeles CA 90077-1726 |
| Practice Telephone | 3105740487 |
| Mailing Telephone | 3104749809 |
| Enumeration Date | 2011-02-25 |
| Last Update Date | 2011-02-25 |
| Authorized Official Name | FREDERIC NICOLA (PRESIDENT) |
| Authorized Official Telephone | 3105740487 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | FREDERIC G NICOLA, MD, A PROFESSIONAL CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417255316 | Frederic G Nicola, Md, A Professional Corporation | Orthopaedic Surgery | 13160 Mindanao Way, Ste 300, Marina Del Rey, CA 90292-6358 | 2011-03-02 |
| Street Address |
13160 MINDANAO WAY STE 300 |
| City | MARINA DEL REY |
| State | CA |
| Zip Code | 90292-6358 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396742813 | Terry David Krekorian | Anesthesiology | 13160 Mindanao Way, Marina Del Rey, CA 90292-6358 | 2005-06-29 |
| 1760984033 | Providence Healthcare Inc | Orthopaedic Surgery | 13160 Mindanao Way, Marina Del Rey, CA 90292-6358 | 2018-03-02 |
| 1487102836 | Disc Physician Group | Surgery | 13160 Mindanao Way, Suite 170, Marina Del Rey, CA 90292-6358 | 2016-09-14 |
| 1215329370 | Holley Alexander Spears | Physician Assistant | 13160 Mindanao Way, Ste 300, Marina Del Rey, CA 90292-6393 | 2015-02-26 |
| 1184049132 | Jeremy Scott Summers | Chiropractor | 13160 Mindanao Way, Suite 308, Marina Del Rey, CA 90292-6358 | 2014-02-27 |
| 1851736615 | Melamed Spine LLC | Physician Assistant | 13160 Mindanao Way, Ste 300, Marina Del Rey, CA 90292-6358 | 2013-05-07 |
| 1073874863 | David Kaplowitz | Internal Medicine | 13160 Mindanao Way, Suite 252, Marina Del Rey, CA 90292-6358 | 2012-06-07 |
| 1134498777 | Lisa Anne Penny | Marriage & Family Therapist | 13160 Mindanao Way, #300, Marina Del Rey, CA 90292-6358 | 2011-12-28 |
| 1922307669 | Gary Brazina Md Inc. | Non-Pharmacy Dispensing Site | 13160 Mindanao Way, Ste 300, Marina Del Rey, CA 90292-6358 | 2011-03-21 |
| 1346548690 | Layla Nina Sotoodeh | Physician Assistant | 13160 Mindanao Way, Suite 300, Marina Del Rey, CA 90292-6358 | 2011-03-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972142420 | Katy Kleinberg | Physical Therapist | 4820 Lincoln Blvd., Marina Del Rey, CA 90292 | 2020-01-02 |
| 1568028330 | Kylie Nakamine | Physical Therapist | 4820 Lincoln Bld, Marina Del Rey, CA 90292 | 2019-05-16 |
| 1033627807 | Kareema Nasouf | Social Worker | 578 Washington Blvd. #815, Marina Del Rey, CA 90292 | 2018-01-16 |
| 1861916611 | Jaqueline Berenice Higbee | Behavior Technician | 13428 Maxella Ave Apt 913, Marina Del Rey, CA 90292 | 2017-08-02 |
| 1063942696 | Luis Albert Japngie | Chiropractor | 13816 Bora Bora Way, A-109, Marina Del Rey, CA 90292 | 2017-06-15 |
| 1427509082 | Melissa Dowling | Nurse Anesthetist, Certified Registered | 4750 Lincoln Blvd Apt 477, Marina Del Rey, CA 90292 | 2016-10-19 |
| 1578932950 | Gratto Aquatic Rehab | Clinic/Center | 13160 Mindanao Way Ste. 308, Marina Del Ray, CA 90292 | 2015-09-16 |
| 1285018309 | Reed Chiropractic & Wellness Center A Professional Corporation | Chiropractor | 4207 Del Rey Ave., Marina Del Rey, CA 90292 | 2015-07-18 |
| 1083990725 | James J Kim | Pharmacist | 4009 Lincoln Blvd., Walgreens, Marina Del Rey, CA 90292 | 2011-10-26 |
| 1689957805 | Medbil, LLC | Anesthesiology | 1024 Oxford Ave., Marina Del Rey, CA 90292 | 2011-09-23 |
| Find all providers in zip 90292 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013273002 | Akash Bajaj Md Inc, A California Professional Medical Corporation | Non-Pharmacy Dispensing Site | 13160 Mindanao Way Ste 300, Marina Del Rey, CA 90292-6393 | 2012-04-04 |
| 1255609004 | Jeremy E. Korman Md, A Professional Corporation | Non-Pharmacy Dispensing Site | 4644 Lincoln Blvd, Suite 450, Marina Del Rey, CA 90292-6313 | 2011-12-08 |
| 1922307669 | Gary Brazina Md Inc. | Non-Pharmacy Dispensing Site | 13160 Mindanao Way, Ste 300, Marina Del Rey, CA 90292-6358 | 2011-03-21 |
| 1497053391 | Edward Carden, Md, Inc. | Non-Pharmacy Dispensing Site | 13160 Mindanao Way, Suite 300, Marina Del Rey, CA 90292-6358 | 2011-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982225496 | Artius Dermatology Associates PC | Non-Pharmacy Dispensing Site | 5757 Pacific Ave Ste 228, Stockton, CA 95207-5159 | 2020-05-06 |
| 1285268391 | Artius Dermatology Associates PC | Non-Pharmacy Dispensing Site | 1337 S Lovers Ln Ste D, Visalia, CA 93292-5249 | 2020-02-27 |
| 1790327732 | Triumph Specialties LLC | Non-Pharmacy Dispensing Site | 11100 Sepulveda Blvd # 8-519, Mission Hills, CA 91345-1131 | 2019-10-10 |
| 1487210365 | Artius Dermatology Associates P.C. | Non-Pharmacy Dispensing Site | 325 Mall Dr Ste 111, Hanford, CA 93230-5950 | 2019-05-15 |
| 1376030080 | Jane F Kardashian Md Inc | Non-Pharmacy Dispensing Site | 6769 N Fresno, Fresno, CA 93710 | 2018-04-18 |
| 1023511045 | Performance Health Medical Group | Non-Pharmacy Dispensing Site | 25431 Cabot Road Suite 118, Laguna Hills, CA 92653 | 2018-03-15 |
| 1043719206 | Southern California Orthopedic Institute L.p | Non-Pharmacy Dispensing Site | 4100 Empire Dr Ste 120, Bakersfield, CA 93309-0408 | 2018-02-02 |
| 1174032353 | Golden Gate Urology, Inc. | Non-Pharmacy Dispensing Site | 139 Townsend St Ste 100, San Francisco, CA 94107-1946 | 2017-09-20 |
| 1215462080 | Mas Management Group, Inc. | Non-Pharmacy Dispensing Site | 28446 Constellation Rd, Valencia, CA 91355-5081 | 2017-04-28 |
| 1730624719 | St. John's Well Child and Family Center Inc | Non-Pharmacy Dispensing Site | 326 W 23rd St, Los Angeles, CA 90007-2612 | 2016-12-29 |
| Find all providers with the same taxonomy | ||||
| City | MARINA DEL REY |
| Zip Code | 90292 |
Please comment or provide details below to improve the information on FREDERIC G NICOLA, MD, A PROFESSIONAL CORPORATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.