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General NPI Number Information
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NPI Number | 1932605201
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Entity Type | Individual
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Provider Name | NICHOLAS GENOVESE MD
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Gender | Male
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Dates
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Enumeration Date | 04/04/2018
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 5395 RUFFIN RD STE 201
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City | SAN DIEGO
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State | CA
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Zip | 92123-1338
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Country | US
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Telephone | 858-560-0242
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Fax |
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Provider Business Mailing Address
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Address Line | 1222 LADERA LINDA
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City | DEL MAR
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State | CA
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Zip | 92014-3944
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Country | US
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Telephone | 908-239-6938
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 25MA12348800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | A197133
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MD486372
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License Number State | PA
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