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General NPI Number Information
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NPI Number | 1831513225
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Entity Type | Individual
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Provider Name | NICOLE JIAM MD
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Gender | Female
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Dates
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Enumeration Date | 02/06/2014
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 1001 POTRERO AVE. BLDG. 5, #4M
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City | SAN FRANCISCO
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State | CA
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Zip | 94110
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Country | US
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Telephone | 628-206-5476
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 743749
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City | LOS ANGELES
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State | CA
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Zip | 90074
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | A160753
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 1014504
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License Number State | MA
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