Nicole Izetta Bostic in Riverside - Pediatrics
Nicole Izetta Bostic - NPI 1417159161
Nicole Izetta Bostic is a Pediatrics in Riverside, California. Nicole Izetta Bostic practices all healthcare services and medical treatments related to Pediatrics. The NPI Number for Nicole Izetta Bostic is 1417159161. The last update date is 2015-03-18.
Nicole Izetta Bostic's current location address is 9041 Magnolia Ave, Riverside, California. You can contact this provider via phone number 9513433481. The mailing address for Nicole Izetta Bostic is 9041 Magnolia Ave, Riverside, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Nicole Izetta Bostic |
|---|---|
| Address | 9041 Magnolia Ave, Riverside, California |
| Phone Number | 9513433481 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1417159161 |
|---|---|
| Provider Enumeration Date | 2007-06-04 |
| Last Updated Date | 2015-03-18 |
Provider Mailing Address Detail
| Address | 9041 Magnolia Ave |
|---|---|
| City | Riverside |
| State | California (CA) |
| Post Code | 925033900 |
| Phone Number | 9513433481 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Pediatrics |
|---|---|
| Taxonomy | 208000000X |
| Licence No | 2007018726 |
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Definition: A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 207418500 | MO | -- |
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What is the unique 10-digit identification code issued to Nicole Izetta Bostic by the Centers for Medicare & Medicaid Services?
The Nicole Izetta Bostic has been assigned the NPI (National Provider Identifier) 1417159161 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you share the physical location details of Nicole Izetta Bostic?
The Nicole Izetta Bostic is situated at 9041 Magnolia Ave, in the city of Riverside, state of CA, with the zip code 925033900.
What is Nicole Izetta Bostic's specialized field of practice, and what is the corresponding taxonomy classification code?
The Nicole Izetta Bostic's area of specialization is Pediatrics, and the corresponding taxonomy code that categorizes this field of practice is 208000000X.
On what date did the Nicole Izetta Bostic receive the assignment of its 1417159161 from the Centers for Medicare & Medicaid Services?
The Nicole Izetta Bostic was issued its 1417159161 by the Centers for Medicare & Medicaid Services on 2007-06-04.
As of what date were the details related to Nicole Izetta Bostic most recently updated or revised?
The information pertaining to Nicole Izetta Bostic, including its address, specialty, and other relevant details, was last updated or revised on 2015-03-18.
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