NICHOLE RENEE MATLICK (NPI# 1982891396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982891396 |
| Entity Type | Individual |
| Full Name | NICHOLE RENEE MATLICK |
| Other Name | NICHOLE RENEE MORGAN |
| Credential | M.D. |
| Practice Address |
510 Superior Ave Ste 200d Newport Beach CA 92663 |
| Mailing Address |
510 Superior Ave Ste 200d Newport Beach CA 92663-3664 |
| Practice Telephone | 9497913001 |
| Mailing Telephone | 9497913001 |
| Enumeration Date | 2007-09-29 |
| Last Update Date | 2018-10-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | A105016 | CA | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | A105016 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | STATE MEDICAL BOARD LICENSE | A105016 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1400 E Church St, Santa Maria, CA 934545906 | 8057393600 | 8057393075 |
| Street Address |
510 SUPERIOR AVE STE 200D |
| City | NEWPORT BEACH |
| State | CA |
| Zip Code | 92663 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104820547 | Kristine Brown | Pediatrics | 510 Superior Ave Ste 200d, Newport Beach, CA 92663 | 2005-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851905483 | Oasis Anesthesia, Surgical and Medical Group, Inc | Anesthesiology | 496 Old Newpor Blvd., Suite 2, Newport Beach, CA 92663 | 2020-09-01 |
| 1699232801 | Megan Gregor | Surgery | One Hoag Dr., Bldg 41, Ste 122, Newport Beach, CA 92663 | 2019-02-24 |
| 1831621382 | Narges Maududi | Social Worker | 1965 Sherrington Place, K111, Newport Beach, CA 92663 | 2017-04-03 |
| 1225495153 | Mitchelle Giorgi | Physical Therapist | 351 Hospital Road, Suite 007, Newport Beach, CA 92663 | 2016-01-22 |
| 1043620057 | Leslie Mccormack | Speech-Language Pathologist | 270 Cagney Lane #101, Newport Beach, CA 92663 | 2014-04-29 |
| 1265867162 | Hotel California By The Sea, LLC | Substance Abuse Rehabilitation Facility | 4504 Seashore Drive, Newport Beach, CA 92663 | 2013-09-10 |
| 1538504733 | Shawn Zardouz | Psychiatry & Neurology | 3900 W Coast Hwy Ste 390, Newport Beach, CA 92663 | 2013-05-02 |
| 1326330119 | Denise Fortenberry Fortenberry-gratias | Nurse Practitioner | 520 Superior Ave, Suite 350, Newport Beach, CA 92663 | 2011-05-11 |
| 1043500390 | Romit Kumar Kar | Pediatrics | 355 Placentia Ave Ste 301, Newport Beach, CA 92663 | 2011-04-07 |
| 1477858546 | Newport Neurohospitalists | Neurological Surgery | 510 Superior Ave Ste 280, Newport Beach, CA 92663 | 2011-01-20 |
| Find all providers in zip 92663 | ||||
| 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 |
|---|---|---|---|---|
| 1649667585 | Taylor Mizell Stukes Duffin | Pediatrics | 1401 Avocado Ave Ste 802, Newport Beach, CA 92660-7784 | 2015-04-17 |
| 1104194679 | Carla Du Mont | Pediatrics | 29 Saint Tropez, Newport Beach, CA 92660-6834 | 2011-12-12 |
| 1366729857 | Stephen Cyrus Koffler | Pediatrics | 2906 Catalpa St, Newport Beach, CA 92660-3221 | 2011-11-10 |
| 1043500390 | Romit Kumar Kar | Pediatrics | 355 Placentia Ave Ste 301, Newport Beach, CA 92663 | 2011-04-07 |
| 1477737161 | Nazanin Sanaei | Pediatrics | 307 Placentia Ave Ste 107, Newport Beach, CA 92663-3307 | 2007-12-18 |
| 1093857021 | Richa Lal | Pediatrics | 1401 Avocado Ave Ste 709, Newport Beach, CA 92660 | 2007-02-13 |
| 1982648192 | Jennifer Johnson | Pediatrics | 366 San Miguel Dr, Suite 209, Newport Beach, CA 92660-7817 | 2006-06-16 |
| 1912984741 | David Michelis | Pediatrics | 601 Dover Dr, Suite 7, Newport Beach, CA 92663-5735 | 2005-12-22 |
| 1215929310 | Elizabeth O'connell | Pediatrics | 1401 Avocado Ave, Suite 802, Newport Beach, CA 92660-7720 | 2005-08-16 |
| 1104820547 | Kristine Brown | Pediatrics | 510 Superior Ave Ste 200d, Newport Beach, CA 92663 | 2005-06-13 |
| Find all providers in NEWPORT BEACH | ||||
| City | NEWPORT BEACH |
| Zip Code | 92663 |
Please comment or provide details below to improve the information on NICHOLE RENEE MATLICK.
| 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.