Nicolette Lee Ballou, MD | |
8920 Wilshire Blvd, Ste 604, Beverly Hills, CA 90211 | |
(310) 659-7867 | |
(310) 659-0804 |
Full Name | Nicolette Lee Ballou |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 8920 Wilshire Blvd, Beverly Hills, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1457420077 | NPI | - | NPPES |
00G53313 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | G53313 (California) | Primary |
Entity Name | Prime Wellness Community Health Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083251532 PECOS PAC ID: 3375944150 Enrollment ID: O20210630002908 |
Mailing Address | Practice Location Address |
---|---|
Nicolette Lee Ballou, MD 8920 Wilshire Blvd, Ste 604, Beverly Hills, CA 90211 Ph: (310) 659-7867 | Nicolette Lee Ballou, MD 8920 Wilshire Blvd, Ste 604, Beverly Hills, CA 90211 Ph: (310) 659-7867 |
Dr. Jeffrey P Brown, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 200 N Robertson Blvd, Beverly Hills, CA 90211 Phone: 310-385-3345 Fax: 310-248-7050 | |
Dr. Anita Sabeti, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 9735 Wilshire Blvd, Suite 123, Beverly Hills, CA 90212 Phone: 310-248-2829 | |
Dr. Samuel Sungwon Kim, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 150 N Robertson Blvd Ste 307, Beverly Hills, CA 90211 Phone: 310-659-8687 Fax: 310-659-2420 | |
Carolyn Lee Kipper, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 609 N Arden Dr, Beverly Hills, CA 90210 Phone: 310-278-4004 Fax: 310-278-6798 | |
Reut Ron Pagi, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 8500 Wilshire Blvd Ste 917, Beverly Hills, CA 90211 Phone: 310-789-2058 | |
Dr. Joseph Nadim Sleiman, Pediatrics Medicare: Medicare Enrolled Practice Location: 8501 Wilshire Blvd Ste 201, Beverly Hills, CA 90211 Phone: 310-385-3345 Fax: 310-385-3556 | |
Dr. Vicki Y Shimoyama, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 8501 Wilshire Blvd, #205, Beverly Hills, CA 90211 Phone: 310-385-3345 Fax: 310-248-7010 |