Provider Demographics
NPI:1306076716
Name:BINDER, NICHOLAS RICHARD (MD)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:RICHARD
Last Name:BINDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:320 SANTA FE DRIVE #104
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-5138
Mailing Address - Country:US
Mailing Address - Phone:760-943-7141
Mailing Address - Fax:760-943-0371
Practice Address - Street 1:700 W. EL NORTE PKWY.
Practice Address - Street 2:STE 200
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92026-3923
Practice Address - Country:US
Practice Address - Phone:760-743-5872
Practice Address - Fax:760-743-5879
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA124698207WX0110X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1306076716Medicaid