Provider Demographics
NPI:1720110364
Name:NOURMAND, NICOLE MICHELLE (MD)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:MICHELLE
Last Name:NOURMAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8907 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1937
Mailing Address - Country:US
Mailing Address - Phone:310-247-8687
Mailing Address - Fax:310-859-9131
Practice Address - Street 1:8907 WILSHIRE BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1937
Practice Address - Country:US
Practice Address - Phone:310-247-8687
Practice Address - Fax:310-859-9131
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA89815208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics