MEDICARE: DR. NIKOLAI ALEXANDER BILDZUKEWICZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	A82509	CA

General Provider Information

NPI Number	:	1255547493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NIKOLAI ALEXANDER BILDZUKEWICZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 31309
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90031-0309
Country	:	US
Telephone Number	:	323-442-9062
Fax Number	:

Provider Business Practice Location Address
First Line	:	1950 SUNNY CREST DR STE 2500
Second Line	:
City	:	FULLERTON
State	:	CA
Zip	:	92835-3644
Country	:	US
Telephone Number	:	714-263-9383
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	04/14/2026

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