Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | ||
N | 222Z00000X | Podiatrist | ||
Y | 224P00000X | Prosthetist |
NPI | 1326533738 |
---|---|
Provider Name | Mr. Nicholas D. Madsen |
First Address | Chico, CA 95926-1991 |
Second Address | Oroville, CA 95965-5816 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2018 |
Last Update Date | 25/03/2019 |