| Nicole M. Tyer, M.d., Inc. | |
|
435 N Roxbury Dr Ste 300 Beverly Hills CA 90210-5005 | |
| (310) 278-1388 | |
| Not Available |
| Full Name | Nicole M. Tyer, M.d., Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 435 N Roxbury Dr Ste 300, Beverly Hills, California |
| Authorized Official Name and Position | Nicole Marie Tyer (PHYSICIAN) |
| Authorized Official Contact | 9175441982 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole M. Tyer, M.d., Inc. 435 N Roxbury Dr Ste 300 Beverly Hills CA 90210-5005 Ph: (310) 278-1388 | Nicole M. Tyer, M.d., Inc. 435 N Roxbury Dr Ste 300 Beverly Hills CA 90210-5005 Ph: (310) 278-1388 |
| NPI Number | 1700593043 |
|---|---|
| Provider Enumeration Date | 11/04/2022 |
| Last Update Date | 11/04/2022 |
| Medicare PECOS PAC ID | 1355712936 |
|---|---|
| Medicare Enrollment ID | O20230118000714 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700593043 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Nicole M Tyer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346400785 PECOS PAC ID: 1355536160 Enrollment ID: I20101105000933 |
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