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General NPI Number Information
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NPI Number | 1134311517
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Entity Type | Individual
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Provider Name | NICHOLAS JOSEPH MINIEL MD
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Gender | Male
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Dates
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Enumeration Date | 08/09/2007
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Last Update Date | 09/13/2021
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Provider Practice Location Address
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Address Line | 1759 BELOIT AVE APT 201
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City | LOS ANGELES
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State | CA
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Zip | 90025-4257
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Country | US
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Telephone | 206-473-1141
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Fax |
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Provider Business Mailing Address
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Address Line | 10531 4S COMMONS DR # 166-405
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City | SAN DIEGO
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State | CA
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Zip | 92127-3517
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Country | US
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Telephone | 877-381-4115
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Fax | 858-901-1461
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A108183
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License Number State | CA
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