Dr. Carl Nordstrom, M.D.
Internal Medicine, Gastroenterology in Santa Monica, CA. Individual provider (NPI-1).
NPI number1528298528
StatusActive
Last updated in NPPESJan 12, 2018
Details
- NPI
- 1528298528
- Entity type
- Individual (NPI-1)
- Name
- Dr. Carl Nordstrom
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 23, 2009
- Last updated
- Jan 12, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RG0100X | Internal Medicine, Gastroenterology | A116293 | CA | Yes |
| 207R00000X | Internal Medicine | A116293 | CA |
Practice location
1223 16th St Ste 3100Santa Monica, CA 90404-1275
Phone 310-582-6240 · Fax 424-259-7788
Mailing address
8700 Beverly BlvdRm 5512
West Hollywood, CA 90048-1804
Phone 310-423-5161
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