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General NPI Number Information
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NPI Number | 1992445324
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Entity Type | Individual
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Provider Name | NICHOLAS PREWITT MD
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Gender | Male
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Dates
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Enumeration Date | 04/01/2022
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 5555 W LAS POSITAS BLVD
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City | PLEASANTON
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State | CA
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Zip | 94588-4000
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Country | US
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Telephone | 844-301-0805
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 920133
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City | DALLAS
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State | TX
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Zip | 75392-0133
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Country | US
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Telephone | 877-346-2211
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A200408
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License Number State | CA
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