Nickerson, Derek Walter

Nickerson, Derek Walter is an sole proprietor health care provider with primary practice located at 1934 Via Ctr Ste B , Vista CA 92081-6056. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is his primary health care specialty. Nickerson, Derek Walter can be contacted via phone (760) 295-2299.

Contact Information

Primary practice address
1934 Via Ctr Ste B Vista CA 92081-6056
Phone: (760) 295-2299
Fax: (760) 216-5300
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X A171167 California
Allopathic & Osteopathic Physicians / Dermatology 207N00000X LL41017 South Carolina
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X A171167 California

Profile Details

NPI number 1265895619
LBN Legal business name Nickerson, Derek Walter
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 2nd, 2016
Last updated Jun 8th, 2021 - about 3 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.

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