Michael W. Niccole, Md, Inc.

NPI #1184909327 in Corona Del Mar, California

Provider Information

NPI Number: 1184909327
Entity Type: Organization
Organization Name: Michael W. Niccole, Md, Inc.
Primary Specialty: Specialist
Enumeration Date: Oct 19, 2011
Last Updated: Oct 19, 2011

Practice Location

Address: 1101 BAYSIDE DR
Address 2: SUITE 100
City: Corona Del Mar
State: California
ZIP Code: 92625-1702
Phone: (949) 718-6900

Authorized Official

Name: MRS. APRIL R LEE
Title: ADMINISTRATION
Phone: (949) 718-6900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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