Provider Demographics
NPI:1376263012
Name:NADELSON MEDICAL OF CA, PC
Entity type:Organization
Organization Name:NADELSON MEDICAL OF CA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:NADELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:844-843-4836
Mailing Address - Street 1:53 W 36TH ST RM 204
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-7624
Mailing Address - Country:US
Mailing Address - Phone:844-843-4836
Mailing Address - Fax:
Practice Address - Street 1:9201 W SUNSET BLVD STE 415
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90069-3705
Practice Address - Country:US
Practice Address - Phone:618-917-3919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center