| Ethan Aolphus Nicholls, MD | |
|
3200 Kearney St, Fremont, CA 94538-2299 | |
| (510) 490-1222 | |
| Not Available |
| Full Name | Ethan Aolphus Nicholls |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology |
| Experience | 37 Years |
| Location | 3200 Kearney St, Fremont, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801805106 | NPI | - | NPPES |
| 00G679150 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | G67915 (California) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Sutter Bay Medical Foundation | 4284538778 | 3318 |
| Entity Name | Sutter Bay Medical Foundation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013950807 PECOS PAC ID: 4284538778 Enrollment ID: O20031125000909 |
| Entity Name | Sutter Bay Medical Foundation |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1982845186 PECOS PAC ID: 4284538778 Enrollment ID: O20090501000247 |
| Entity Name | Sutter Bay Medical Foundation |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1104067115 PECOS PAC ID: 4284538778 Enrollment ID: O20090501000456 |
| Entity Name | Sutter Bay Medical Foundation |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1497996524 PECOS PAC ID: 4284538778 Enrollment ID: O20090506000097 |
| Mailing Address | Practice Location Address |
|---|---|
| Ethan Aolphus Nicholls, MD 325 Distel Cir, Los Altos, CA 94022-1408 Ph: (510) 490-1222 | Ethan Aolphus Nicholls, MD 3200 Kearney St, Fremont, CA 94538-2299 Ph: (510) 490-1222 |
Shurea A. Wilson, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 39400 Paseo Padre Pkwy, Fremont, CA 94538 Phone: 510-795-3000 | |
Joan June Chen, Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2000 Mowry Ave, Fremont, CA 94538 Phone: 510-797-1111 | |
Surinder Sandhu, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 2299 Mowry Ave, Fremont, CA 94538 Phone: 510-791-5374 | |
Dr. Abhilasha Solanki, M.D Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 39400 Paseo Padre Pkwy, Fremont, CA 94538 Phone: 510-248-3000 | |
Brian E Smith, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 2000 Mowry Ave, Fremont, CA 94538 Phone: 510-797-1111 | |
Stephen R Shuput, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 43314 Banda Ter, Fremont, CA 94539 Phone: 800-991-6704 Fax: 408-444-8845 | |
Ann Marie Mallat, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 3200 Kearney St., Fremont, CA 94538 Phone: 510-490-1222 |