MR. MERVYN BERTRAND NICHOLAS PA NPI 1104854728

NPI Information

NPI: 1104854728
Provider Name: MR. MERVYN BERTRAND NICHOLAS, PA
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Address:
5505 BORDEAUX CT
VALLEJO, CA
ZIP 94591
Phone: (707) 980-0372
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MR. Mervyn Bertrand Nicholas, PA is a medical physician assistant in Vallejo, CA. MR. Mervyn Bertrand Nicholas, PA NPI is 1104854728. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5505 BORDEAUX CT
VALLEJO, CA
ZIP 94591-308
Phone: (707) 980-0372
Fax: (925) 372-2804

The enumeration date for this NPI number is 6/30/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA15023	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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