Bambi L Nickelberry MD Professional Corporation
Family Medicine, Adult Medicine in Inglewood, CA. Organization (NPI-2).
NPI number1972772655
StatusActive
Last updated in NPPESJun 21, 2022
Details
- NPI
- 1972772655
- Entity type
- Organization (NPI-2)
- Legal business name
- Bambi L Nickelberry MD Professional Corporation
- Organization subpart
- No
- Enumeration date
- Feb 26, 2008
- Certification date
- Jun 21, 2022
- Last updated
- Jun 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207QA0505X | Family Medicine, Adult Medicine | G466791 | CA | Yes |
Practice location
248 N Locust StInglewood, CA 90301-1258
Phone 310-673-3737 · Fax 310-673-0248
Mailing address
248 N Locust StInglewood, CA 90301-1258
Phone 310-673-3737 · Fax 310-673-0248
Authorized official
Bambi Lynn Nickelberry
Director/Owner
3106733737
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