Provider Demographics
NPI:1871605659
Name:NICHOLS, JAMES F (MD)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:F
Last Name:NICHOLS
Suffix:
Gender:M
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:PO BOX 1943
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93303-1943
Mailing Address - Country:US
Mailing Address - Phone:661-324-6588
Mailing Address - Fax:661-322-8356
Practice Address - Street 1:1914 TRUXTUN AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-5011
Practice Address - Country:US
Practice Address - Phone:661-324-6588
Practice Address - Fax:661-322-8356
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG602102085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG60210OtherLIC#
CAXR059834FMedicaid
CAG60210OtherLIC#
CAXR059834FMedicaid