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General NPI Number Information
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NPI Number | 1770772527
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Entity Type | Organization
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Legal Business Name | MIHOKO NELSEN M.D. INC
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Dates
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Enumeration Date | 10/17/2007
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Last Update Date | 11/09/2010
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Provider Practice Location Address
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Address Line | 630 S RAYMOND AVE SUITE 340
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City | PASADENA
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State | CA
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Zip | 91105-3278
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Country | US
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Telephone | 626-792-8154
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Fax | 626-793-6174
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Provider Business Mailing Address
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Address Line | 630 S RAYMOND AVE SUITE 340
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City | PASADENA
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State | CA
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Zip | 91105-3278
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Country | US
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Telephone | 626-792-8154
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Fax | 626-793-6174
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Authorized Official
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Title or Position | DOCTOR
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Name | MIHOKO M NELSEN
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Credential | M.D.
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Telephone | 626-792-8154
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | G37022
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License Number State | CA
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