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NPI Code Detail

MEDICARE: NICO BISHOP

MEDICARE: NICO BISHOP
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
1171100000XAcupuncturistAC15205CA

General Provider Information

NPI Number : 1528498946
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICO BISHOP
Provider Business Mailing Address
First Line : 15550 ROCKFIELD BLVD
Second Line : SUITE B220
City : IRVINE
State : CA
Zip : 92618-2720
Country : US
Telephone Number : 949-598-9999
Fax Number : 949-598-9990
Provider Business Practice Location Address
First Line : 1511 TREAT BLVD
Second Line : #100
City : WALNUT CREEK
State : CA
Zip : 94598-1094
Country : US
Telephone Number : 925-949-8911
Fax Number : 925-949-8322
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2013
Last Update Date : 11/21/2013

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Directions to “ NICO BISHOP ” Practice Location

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