Provider Demographics
NPI:1487479614
Name:NICHOLAS GENERALES, D.O., INC.
Entity type:Organization
Organization Name:NICHOLAS GENERALES, D.O., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:FURLONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-865-1611
Mailing Address - Street 1:807 N. KEMP ST.
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505
Mailing Address - Country:US
Mailing Address - Phone:818-426-6864
Mailing Address - Fax:
Practice Address - Street 1:7345 MEDICAL CENTER DRIVE
Practice Address - Street 2:SUITE 540
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307
Practice Address - Country:US
Practice Address - Phone:818-992-0331
Practice Address - Fax:818-992-0337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty