Healthcare Provider Details

I. General information

NPI: 1447719760
Provider Name (Legal Business Name): NIKOLAS ROBERT BLOCK-WHEELER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2019
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 UNION ST STE 480
SAN FRANCISCO CA
94123-4128
US

IV. Provider business mailing address

2001 UNION ST STE 480
SAN FRANCISCO CA
94123-4128
US

V. Phone/Fax

Practice location:
  • Phone: 415-320-7720
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberA181590
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License NumberA181590
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberA181590
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License NumberA181590
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: