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General NPI Number Information
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NPI Number | 1376878470
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Entity Type | Individual
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Provider Name | NIKOLAS V. CHUGAY SR. D.O.
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Gender | Male
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Dates
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Enumeration Date | 10/07/2009
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Last Update Date | 10/07/2009
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Provider Practice Location Address
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Address Line | 4210 ATLANTIC AVE
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City | LONG BEACH
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State | CA
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Zip | 90807-2802
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Country | US
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Telephone | 562-595-8507
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Fax | 562-988-9220
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Provider Business Mailing Address
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Address Line | 4210 ATLANTIC AVE
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City | LONG BEACH
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State | CA
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Zip | 90807-2802
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Country | US
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Telephone | 562-595-8507
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Fax | 562-988-9220
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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 | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number | 20A3830
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 20A3830
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License Number State | CA
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