Healthcare Provider Details

I. General information

NPI: 1902941867
Provider Name (Legal Business Name): NICHOLAS GIARDINI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 NORRIS CANYON RD PEDIATRICS, ROOM 142
SAN RAMON CA
94583-5400
US

IV. Provider business mailing address

3 ROMAIN ST
SAN FRANCISCO CA
94114-2733
US

V. Phone/Fax

Practice location:
  • Phone: 925-275-8848
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG61115
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: