Krystyna E Mcnicoll (NPI# 1750392247, PAC ID# 7416929872) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1750392247 |
| PAC ID by PECOS | 7416929872 |
| Professional Enrollment ID | I20040807000231 |
| Full Name | Krystyna E Mcnicoll |
| Organization Legal Name | PACIFIC PALISADES MEDICAL GROUP INC |
| Address |
15200 W Sunset Blvd Suite 107 Pacific Palisades CA 90272-3620 |
| Phone Number | 3104597736 |
| Gender | F |
| Credential | MD |
| Medical School | UNIVERSITY OF CALIFORNIA, UCLA SCHOOL OF MEDICINE |
| Graduation Year | 1982 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 1153393517 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050262 | RONALD REAGAN U C L A MEDICAL CENTER |
| 050112 | SANTA MONICA - UCLA MED CTR & ORTHOPAEDIC HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 15200 W Sunset Blvd, Suite 107, Pacific Palisades, CA 90272-3620 | 3104597736 | PACIFIC PALISADES MEDICAL GROUP INC |
| Organization Legal Name | PACIFIC PALISADES MEDICAL GROUP INC |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gary A Green | Family Medicine | Pacific Palisades Medical Group Inc | 15200 W Sunset Blvd, Suite 107, Pacific Palisades, CA 90272-3620 |
| Julie M Ma | Internal Medicine | Pacific Palisades Medical Group Inc | 15200 W Sunset Blvd, Suite 107, Pacific Palisades, CA 90272-3620 |
| Richard A Johnson | Internal Medicine | Pacific Palisades Medical Group Inc | 15200 W Sunset Blvd, Suite 107, Pacific Palisades, CA 90272-3620 |
| Street Address |
15200 W SUNSET BLVD SUITE 107 |
| City | PACIFIC PALISADES |
| State | CA |
| Zip | 90272-3620 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gary A Green | Family Medicine | Pacific Palisades Medical Group Inc | 15200 W Sunset Blvd, Suite 107, Pacific Palisades, CA 90272-3620 |
| Julie M Ma | Internal Medicine | Pacific Palisades Medical Group Inc | 15200 W Sunset Blvd, Suite 107, Pacific Palisades, CA 90272-3620 |
| Richard A Johnson | Internal Medicine | Pacific Palisades Medical Group Inc | 15200 W Sunset Blvd, Suite 107, Pacific Palisades, CA 90272-3620 |
| Ashley Laine Olsen | Physical Therapy | Rancho Physical Therapy Inc | 15200 W Sunset Blvd, Suite 111, Pacific Palisades, CA 90272-3620 |
| Robert B Shields | Physical Therapy | Rancho Physical Therapy, Inc. | 15200 W Sunset Blvd, Suite 111, Pacific Palisades, CA 90272-3620 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Francine Kirkpatrick | Clinical Psychologist | 16050 Anoka Dr, Pacific Palisades, CA 90272-2410 | |
| Laure Weber | Psychologist, Clinical | 1136 Embury St, Pacific Palisades, CA 90272-2503 | |
| John T Pietrzak | Psychologist, Clinical | 15340 Albright St, Unit 106, Pacific Palisades, CA 90272-2518 | |
| Luke S Cohen | Chiropractic | Luke S Cohen Professional Chiropractic Corporation | 16624 Marquez Ave, Pacific Palisades, CA 90272-3233 |
| Ileana E Zapatero | Dermatology | 910 Via De La Paz, Suite 205, Pacific Palisades, CA 90272-3545 | |
| Dana G Holcomb | Dermatology | 910 Via De La Paz, Suite 205, Pacific Palisades, CA 90272-3545 | |
| Shannon G Watson | Chiropractic | 910 Via De La Paz, Suite 102, Pacific Palisades, CA 90272-3568 | |
| Mark R Sawusch | Ophthalmology | 910 Via De La Paz, Suite 208, Pacific Palisades, CA 90272-3592 | |
| Ann M Marraccini | Physical Therapy | The Cypress Center A Physical Therapy Corporation | 860 Via De La Paz, B1, Pacific Palisades, CA 90272-3681 |
| Rachel L Clark | Physical Therapy | The Cypress Center A Physical Therapy Corporation | 860 Via De La Paz, B1, Pacific Palisades, CA 90272-3681 |
| Find all physicians in zip 90272 | |||
| City | PACIFIC PALISADES |
| Zip Code | 90272 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | PACIFIC PALISADES + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Krystyna E Mcnicoll.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.