MEDICARE: DR. NICHOLAS JOSEPH CELANO 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	174400000X	Specialist	A120411	CA
2	207NP0225X	Pediatric Dermatology Physician	A120411	CA
3	207N00000X	Dermatology Physician	A120411	CA

General Provider Information

NPI Number	:	1457662264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICHOLAS JOSEPH CELANO M.D.

Provider Business Mailing Address
First Line	:	655 EUCLID AVE STE 304
Second Line	:
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-2974
Country	:	US
Telephone Number	:	619-267-8303
Fax Number	:	619-267-4835

Provider Business Practice Location Address
First Line	:	655 EUCLID AVE STE 401
Second Line	:
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-2978
Country	:	US
Telephone Number	:	619-267-8303
Fax Number	:	619-267-4835

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

Provider Enumeration Date	:	06/25/2010
Last Update Date	:	09/12/2024

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Directions to “ DR. NICHOLAS JOSEPH CELANO M.D.” Practice Location

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