Provider Demographics
NPI:1992432454
Name:ABERGEL, NICOLE (IRPH)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:ABERGEL
Suffix:
Gender:F
Credentials:IRPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6420 QUEBEC DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90068-2834
Mailing Address - Country:US
Mailing Address - Phone:818-274-4412
Mailing Address - Fax:
Practice Address - Street 1:6420 QUEBEC DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90068-2834
Practice Address - Country:US
Practice Address - Phone:818-274-4412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44608183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist