BAMBI L. NICKELBERRY, M.D. (NPI# 1972772655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972772655 |
| Entity Type | Organization |
| Organization Name | BAMBI L. NICKELBERRY, M.D. |
| Practice Address |
248 N Locust St Inglewood CA 90301-1258 |
| Practice Telephone | 3106733737 |
| Practice Fax Number | 3106730248 |
| Mailing Telephone | 3106733737 |
| Mailing Fax Number | 3106730248 |
| Enumeration Date | 2008-02-26 |
| Last Update Date | 2008-05-05 |
| Authorized Official Name | DR. BAMBI LYNN NICKELBERRY (DIRECTOR/OWNER) |
| Authorized Official Telephone | 3106733737 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
G466791 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G466791 | 05 |
| Street Address |
248 N LOCUST ST |
| City | INGLEWOOD |
| State | CA |
| Zip Code | 90301-1258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669492856 | Windgrove David Daniel | Internal Medicine | 248 N Locust St, Inglewood, CA 90301-1204 | 2006-07-20 |
| 1104084623 | Bullis Family Medical | Family Medicine | 248 N Locust St, Inglewood, CA 90301-1258 | 2008-05-30 |
| 1528113149 | Los Angeles Multispecialty Medical Group | Internal Medicine | 248 N Locust St, Inglewood, CA 90301-1258 | 2007-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548897945 | Genevieve V. Angel | Registered Nurse | 555 East Hardy Street, Director of Cm Sw, Centinela Hospital Medical Center, Inglewood, CA 90301 | 2020-03-25 |
| 1992338552 | Ralph Kevin Roque | Licensed Practical Nurse | 614 W Manchester Blvd, Inglewood, Ca 90301, 104, Inglewood, CA 90301 | 2020-02-21 |
| 1043841562 | Evelyn Jones | Social Worker | 555 E. Hardy Street, Inglewood, Ca, CA 90301 | 2020-02-03 |
| 1447896444 | Coral Dabarera Edelson | Dietitian, Registered | 110 North La Brea Ave, Inglewood, CA 90301 | 2019-11-25 |
| 1821642125 | Jennifer Robert Umoh | Student in an Organized Health Care Education/Training Program | 412 E Florence Avenue, Inglewood, CA 90301 | 2019-07-25 |
| 1821567751 | Esther Voltaire | Behavior Technician | 619 E Arbor Vitae St, Inglewood, CA 90301 | 2018-11-21 |
| 1902372832 | Pool Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 323 North Prairie Ave, Suite 200, Ingelwood, CA 90301 | 2018-10-18 |
| 1174003594 | Xelnt Healthcare Inc. | Clinic/Center | 501 E Hardy St Ste 425, Inglewood, CA 90301 | 2018-08-15 |
| 1710409321 | Rae Shelston Mcintosh | Licensed Vocational Nurse | 1007 Myrth Ave, Inglewood, CA 90301 | 2017-07-14 |
| 1477093789 | Lewis E Logan II | Counselor | 332 N. Prairie Ave., Suite 417, Inglewood, CA 90301 | 2017-03-06 |
| Find all providers in zip 90301 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689782013 | Danielle L Davidson-mcbean | Family Medicine | 110 North Labrea Ave, Inglewood, CA 90301-1708 | 2006-08-27 |
| 1003008103 | H Milano Mellon Md Inc | Family Medicine | 915 Myrtle Ave, Inglewood, CA 90301-4007 | 2007-08-13 |
| 1336170877 | Marvin White | Family Medicine | 11161 Crenshaw Blvd, Suite 210, Inglewood, CA 90303-2336 | 2006-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306446091 | Candace Maglinao | Family Medicine | 21010 Anza Ave Apt 12, Torrance, CA 90503-4254 | 2020-10-30 |
| 1942826797 | In-home Medical Mobile Services, Inc. | Family Medicine | 3400 E 8th St Ste 202, National City, CA 91950-3169 | 2020-06-17 |
| 1386269306 | Universal Mobile Doctors Inc | Family Medicine | 15333 Sherman Way Ste P, Van Nuys, CA 91406-4204 | 2020-06-16 |
| 1619597671 | Harry Eisenbach | Family Medicine | 9312 Smoketree Ln, Villa Park, CA 92861-1011 | 2020-04-20 |
| 1669092854 | Wellbeing Clinic Inc | Family Medicine | 1621 S New Hampshire Ave, Los Angeles, CA 90006-4513 | 2020-04-17 |
| 1619513611 | Krista Mckinney | Family Medicine | 344o E. La Palma Avenue, Anaheim, CA 92806 | 2019-11-25 |
| 1457995565 | Ucsf Medical Group Business Services | Family Medicine | 1100 Park Pl Ste 100, San Mateo, CA 94403-7119 | 2019-10-31 |
| 1780237313 | Charles Kim Md Inc | Family Medicine | 3055 W Orange Ave Ste 204, Anaheim, CA 92804-3154 | 2019-07-23 |
| 1083277206 | Baum 5 Star Healthcare | Family Medicine | 560 W Grangeville Blvd Ste A, Hanford, CA 93230-2858 | 2019-04-15 |
| 1477025278 | Connexus Family Clinic Inc | Family Medicine | 1930 E. Anaheim Street, N/a, Long Beach, CA 90813-3908 | 2018-12-19 |
| Find all providers with the same taxonomy | ||||
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| 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.