| Douglas Nitta, M.d., Inc. | |
|
301 W. Bastanchury Road Suite 155 Fullerton CA 92835 | |
| (714) 773-1116 | |
| Not Available |
| Full Name | Douglas Nitta, M.d., Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 301 W. Bastanchury Road, Fullerton, California |
| Authorized Official Name and Position | Douglas Nitta (PRESIDENT) |
| Authorized Official Contact | 7147731116 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Douglas Nitta, M.d., Inc. 301 W. Bastanchury Road Suite 155 Fullerton CA 92835 Ph: () - | Douglas Nitta, M.d., Inc. 301 W. Bastanchury Road Suite 155 Fullerton CA 92835 Ph: (714) 773-1116 |
| NPI Number | 1902115934 |
|---|---|
| Provider Enumeration Date | 09/24/2010 |
| Last Update Date | 09/24/2010 |
| Medicare PECOS PAC ID | 8729104732 |
|---|---|
| Medicare Enrollment ID | O20100928000531 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902115934 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | G45491 (California) | Primary |
| Provider Name | Douglas Nitta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912920125 PECOS PAC ID: 9638295645 Enrollment ID: I20100928000564 |
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