Provider Demographics
NPI:1962741504
Name:CULMAN, NICOLE LEE (DO)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:LEE
Last Name:CULMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7601 HOSPITAL DR STE 103
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-5408
Mailing Address - Country:US
Mailing Address - Phone:916-681-1600
Mailing Address - Fax:
Practice Address - Street 1:7601 HOSPITAL DR STE 103
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-5408
Practice Address - Country:US
Practice Address - Phone:916-681-1600
Practice Address - Fax:916-688-0226
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12618207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine