Brad James Nicoll, P.T.
Physical Therapist, Orthopedic in San Diego, CA. Individual provider (NPI-1).
NPI number1376865337
StatusActive
Last updated in NPPESMar 18, 2016
Details
- NPI
- 1376865337
- Entity type
- Individual (NPI-1)
- Name
- Brad James Nicoll
- Credential
- P.T.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 18, 2010
- Last updated
- Mar 18, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICAL THERAPIST IN PRIVATE PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2251X0800X | Physical Therapist, Orthopedic | 36797 | CA | Yes |
Practice location
15004 Innovation DrSan Diego, CA 92128-3491
Phone 858-605-7189
Mailing address
10790 Rancho Bernardo RdMail Drop 4s-205
San Diego, CA 92127-5705
Phone 858-927-5775
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 109 Orthopedic Physical Therapist providers in San Diego · All 61,118 providers in San Diego
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