Nicollette L. Ballou, M.D.

LBN: Nicollette L. Ballou, M.D.
Nicollette L. Ballou, M.D. is an health care organization with primary practice located at 3831 Hughes Ave Ste 602 , Culver City CA 90232-6845. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Nicollette L. Ballou, M.D. can be contacted via phone (310) 659-7867, or through Ballou, Nicolette Lee via phone (310) 659-7867.

Contact Information

Primary practice address
3831 Hughes Ave Ste 602 Culver City CA 90232-6845
Phone: (310) 659-7867
Fax: (310) 878-2118
Website:
Map and Directions
Authorized official contact:
Name: Ballou, Nicolette Lee Doctor of Medicine (MD)
Phone: (310) 659-7867

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X

Profile Details

NPI number 1790304707
LBN Legal business name Nicollette L. Ballou, M.D.
DBA Doing business as
Authorized official Ballou, Nicolette Lee Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 9th, 2020
Last updated Apr 9th, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790304707 NPPES
California MEDICAID 1457420077

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