Provider Demographics
NPI:1497959332
Name:BIRO, NICOLAS GABRIEL (MD)
Entity Type:Individual
Prefix:
First Name:NICOLAS
Middle Name:GABRIEL
Last Name:BIRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1401 N HILL AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-2615
Mailing Address - Country:US
Mailing Address - Phone:917-348-1060
Mailing Address - Fax:909-206-1097
Practice Address - Street 1:555 N 13TH AVE
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4904
Practice Address - Country:US
Practice Address - Phone:909-277-2420
Practice Address - Fax:909-206-1097
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2021-09-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY247912207WX0200X, 207W00000X
CAC172433207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology