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General NPI Number Information
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NPI Number | 1366189938
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Entity Type | Organization
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Legal Business Name | NICOLE WARD, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 05/16/2022
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 2063 S. ATLANTIC BLVD, SUITE 300
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City | MONTEREY PARK
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State | CA
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Zip | 91754
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Country | US
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Telephone | 818-806-8830
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Fax | 818-536-7695
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Provider Business Mailing Address
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Address Line | 2629 FOOTHILL BLVD # 305
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City | LA CRESCENTA
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State | CA
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Zip | 91214-3511
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Country | US
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Telephone | 818-806-8830
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Fax | 818-536-7695
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Authorized Official
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Title or Position | OWNER
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Name | NICOLE KENDALL WARD
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Credential | DO
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Telephone | 310-473-9400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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