MEDICARE: DR. NICOLAS EDUARDO PALACIOS MEZA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	259187	MA
2	207R00000X	Internal Medicine Physician	298582	NY

General Provider Information

NPI Number	:	1518245638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICOLAS EDUARDO PALACIOS MEZA M.D.

Provider Business Mailing Address
First Line	:	1 EMBARCADERO CTR STE 1900
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94111-3723
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2633 BROADWAY
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10025-5022
Country	:	US
Telephone Number	:	312-219-2230
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2011
Last Update Date	:	11/07/2025

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