NICOLLETTE L. BALLOU, M.D. (NPI# 1790304707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790304707 |
| Entity Type | Organization |
| Organization Name | NICOLLETTE L. BALLOU, M.D. |
| Practice Address |
3831 Hughes Ave Ste 602 Culver City CA 90232-6845 |
| Practice Telephone | 3106597867 |
| Practice Fax Number | 3108782118 |
| Mailing Telephone | 3106597867 |
| Mailing Fax Number | 3108782118 |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2020-04-09 |
| Authorized Official Name | NICOLETTE LEE BALLOU (CEO) |
| Authorized Official Telephone | 3106597867 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1457420077 | 05 |
| Street Address |
3831 HUGHES AVE STE 602 |
| City | CULVER CITY |
| State | CA |
| Zip Code | 90232-6845 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306328430 | Kayla Brass | Physical Therapist | 11056 Washington Blvd Suite C, Culver City, CA 90232 | 2018-09-05 |
| 1861911265 | Caitlyn Handy | Social Worker | 4194 Duquesne Ave, Apt 2, Culver City, CA 90232 | 2017-09-17 |
| 1639695109 | Ashlyn Herrian | Student in an Organized Health Care Education/Training Program | 9808 Venice Blvd., Ste. 505, Culver City, CA 90232 | 2017-08-16 |
| 1922522911 | Kendra Lopez | Rehabilitation Practitioner | 9808 Venice Blvd Suite 700, Culver City, CA 90232 | 2017-08-01 |
| 1740677335 | Michelle Adams | Psychologist | 10866 Washington Blvd #718, Culver City, CA 90232 | 2015-04-21 |
| 1164814976 | Alexander Gersh | Speech-Language Pathologist | 3844 Culver Ctr Ste B, Culver City, CA 90232 | 2015-03-03 |
| 1497161145 | Anila Ladak | Nurse Practitioner | 3828 Delmos Ter, Southern California Hospital At Culver City, Culver City, CA 90232 | 2014-07-02 |
| 1235554908 | Rochelle Skinner Dds Dental Corporation | Dentist | 9702 Venice Blvd, Suite B, Culver City, CA 90232 | 2014-03-04 |
| 1316361173 | Krisena Borenstein | Dentist | 10811 Washington Blvd. Suite #200, Culver City, CA 90232 | 2014-02-13 |
| 1154689925 | Lawrence S Levy | Physical Therapist | 11479 Jefferson Blvd, Culver City, CA 90232 | 2012-04-30 |
| Find all providers in zip 90232 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265757108 | Lauren Wu | Pediatrics | 4700 Inglewood Blvd Ste 101, Culver City, CA 90230-5896 | 2010-04-04 |
| 1114061421 | Margo Patricia Deleaver | Pediatrics | 3831 Hughes Ave Ste 601, Culver City, CA 90232-6844 | 2007-02-19 |
| 1417058140 | Nancy Lee Blumstein | Pediatrics | 9696 Culver Blvd, Suite 108, Culver City, CA 90232 | 2006-09-26 |
| 1518992015 | Yussef Sakhai | Pediatrics | 5797 Washington Blvd, Culver City, CA 90232-7336 | 2006-07-12 |
| 1710538616 | Shannon Jinho Lee | Pediatrics | 5901 Green Valley Cir Ste 130, Culver City, CA 90230-6900 | 2019-09-23 |
| 1366807760 | Medzed Physician Services, Inc. | Pediatrics | 300 Corporate Pointe Ste 465, Culver City, CA 90230 | 2015-12-30 |
| 1841551108 | Yussef Sakhai, M.d., Inc. | Pediatrics | 5797 Washington Blvd, Culver City, CA 90232-7336 | 2012-06-04 |
| 1396906152 | Zarin Nasir Tejani | Pediatrics | 4700 Inglewood Blvd, Culver City, CA 90230-5896 | 2008-06-24 |
| 1710190657 | Michael L Streams | Pediatrics | 4900 Overland Ave, 259, Culver City, CA 90230-4289 | 2007-05-08 |
| 1114062445 | Hubert Anthony Russell | Pediatrics | 3831 Hughes Ave Ste 601, Culver City, CA 90232-6844 | 2007-02-21 |
| Find all providers in CULVER CITY | ||||
| City | CULVER CITY |
| Zip Code | 90232 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.