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General NPI Number Information
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NPI Number | 1760706253
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Entity Type | Organization
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Legal Business Name | NORMAN H NELSON M.D., A MEDICAL CORP
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Dates
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Enumeration Date | 03/26/2010
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Last Update Date | 10/03/2011
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Provider Practice Location Address
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Address Line | 5400 BALBOA BLVD SUITE 141
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City | ENCINO
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State | CA
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Zip | 91316-5203
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Country | US
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Telephone | 818-789-0533
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Fax | 818-789-7642
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Provider Business Mailing Address
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Address Line | 5400 BALBOA BLVD SUITE 141
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City | ENCINO
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State | CA
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Zip | 91316-5203
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Country | US
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Telephone | 818-789-0533
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Fax | 818-789-7642
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. NORMAN H NELSON
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Credential | M.D.
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Telephone | 818-789-0533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | A16140
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License Number State | CA
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