Matlick, Nichole Renee
Matlick, Nichole Renee is an individual health care provider with primary practice located at 510 Superior Ave Ste 200D , Newport Beach CA 92663. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Matlick, Nichole Renee can be contacted via phone (949) 791-3001.Contact Information
Primary practice address
510 Superior Ave Ste 200D
Newport Beach CA 92663
Phone: (949) 791-3001
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | A105016 | California |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | A105016 | California |
Profile Details
| NPI number | 1982891396 |
|---|---|
| LBN Legal business name | Matlick, Nichole Renee |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 29th, 2007 |
| Last updated | Oct 11th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982891396 | NPPES |
| California | Other | A105016 | STATE MEDICAL BOARD LICENSE |
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