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General NPI Number Information
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NPI Number | 1487479614
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Entity Type | Organization
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Legal Business Name | NICHOLAS GENERALES, D.O., INC.
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 7345 MEDICAL CENTER DRIVE SUITE 540
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City | WEST HILLS
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State | CA
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Zip | 91307
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Country | US
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Telephone | 818-992-0331
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Fax | 818-992-0337
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Provider Business Mailing Address
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Address Line | 807 N. KEMP ST.
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City | BURBANK
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State | CA
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Zip | 91505
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Country | US
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Telephone | 818-426-6864
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Fax |
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Authorized Official
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Title or Position | ADMINSTRATOR
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Name | NATALIE E FURLONG
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Credential |
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Telephone | 818-865-1611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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