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General NPI Number Information
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NPI Number | 1619047271
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Entity Type | Individual
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Provider Name | NELLY KIM RICE M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 10/21/2016
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Provider Practice Location Address
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Address Line | 8808 BALBOA AVE
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City | SAN DIEGO
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State | CA
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Zip | 92123-1592
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Country | US
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Telephone | 619-532-8225
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 819 BOX 4581
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City | FPO
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State | AE
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Zip | 09645
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Country | US
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Telephone |
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 44985
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 44985
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License Number State | CO
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