| Nicole Smith, PA-C | |
|
1165 N Euclid St, Anaheim, CA 92801-1938 | |
| (714) 991-9990 | |
| (714) 396-2403 |
| Full Name | Nicole Smith |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 1165 N Euclid St, Anaheim, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902818412 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 20345 (California) | Primary |
| Entity Name | Csi Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871909804 PECOS PAC ID: 5890916845 Enrollment ID: O20141016001930 |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole Smith, PA-C 1165 N Euclid St, Anaheim, CA 92801-1938 Ph: (714) 991-9990 | Nicole Smith, PA-C 1165 N Euclid St, Anaheim, CA 92801-1938 Ph: (714) 991-9990 |
Daisy Hannah Minju Kim, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1230 S Springwood Dr, Anaheim, CA 92808 Phone: 818-748-7211 |
Ferid Addish, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 1105 S Positano Ave, Anaheim, CA 92808 Phone: 714-851-8584 |
Francisco T Torres, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 441 N Lakeview Ave, Anaheim, CA 92807 Phone: 888-988-2800 |
Ms. Tamara Kate Fancher, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 303 W Lincoln Ave Ste 105, Anaheim, CA 92805 Phone: 714-922-1004 |
Ms. Amber Allysen Gally, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 801 E Katella Ave, Anaheim, CA 92805 Phone: 714-633-6373 |
Jenny Nguyen, Physician Assistant Medicare: Medicare Enrolled Practice Location: 631 S Brookhurst St Ste 101, Anaheim, CA 92804 Phone: 714-991-5700 |
Katherine Lilly Boyd-cordova, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 9918 Katella Ave Ste A-c, Anaheim, CA 92804 Phone: 714-644-9494 Fax: 714-644-9894 |