Provider Demographics
NPI:1144381278
Name:NICHOLSON, WILLIAM FRANCIS (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:FRANCIS
Last Name:NICHOLSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2557 MOWRY AVE STE 33
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1614
Mailing Address - Country:US
Mailing Address - Phone:510-745-8100
Mailing Address - Fax:510-797-4983
Practice Address - Street 1:2557 MOWRY AVE STE 33
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1614
Practice Address - Country:US
Practice Address - Phone:510-745-8100
Practice Address - Fax:510-797-4983
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG47903207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G479031Medicaid
00G479030Medicare ID - Type Unspecified
CA00G479031Medicaid