MEDICARE: DR. NADIA NODOUST-CHRISTENSEN MD

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	A64681	CA

General Provider Information

NPI Number	:	1497353239
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NADIA NODOUST-CHRISTENSEN MD

Provider Business Mailing Address
First Line	:	1627 CURTIS AVE
Second Line	:
City	:	MANHATTAN BEACH
State	:	CA
Zip	:	90266-7022
Country	:	US
Telephone Number	:	310-210-8970
Fax Number	:

Provider Business Practice Location Address
First Line	:	1627 CURTIS AVE
Second Line	:
City	:	MANHATTAN BEACH
State	:	CA
Zip	:	90266-7022
Country	:	US
Telephone Number	:	310-210-8970
Fax Number	:

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

Provider Enumeration Date	:	10/14/2020
Last Update Date	:	10/14/2020

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