Provider Demographics
NPI:1922720416
Name:NICOUR LLC
Entity Type:Organization
Organization Name:NICOUR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-771-9988
Mailing Address - Street 1:9528 MIRAMAR RD # 205
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-4533
Mailing Address - Country:US
Mailing Address - Phone:619-771-9988
Mailing Address - Fax:
Practice Address - Street 1:5380 CLAIREMONT MESA BLVD STE 200
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-2677
Practice Address - Country:US
Practice Address - Phone:858-252-0044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty