Active NPI
Beata A Nickel, MD, PHD
- General Practice Physician
- Malibu, CA
National Provider Identifier
1154607000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- A51219
- Practice address
- 18111 Coastline Dr Apt 4
Malibu, CA 90265-5746 - Phone
- (310) 230-4000
- Fax
- (310) 454-1988
- NPI assigned
- Oct 24, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | A51219 | CA | Primary |
Addresses
Primary practice location
18111 Coastline Dr Apt 4
Malibu, CA 90265-5746
Mailing address
18111 Coastline Dr 4
Malibu, CA 90265
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A51219 | CA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319414400000",
"number": "1154607000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18111 COASTLINE DR 4",
"city": "MALIBU",
"state": "CA",
"postal_code": "90265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18111 COASTLINE DR APT 4",
"city": "MALIBU",
"state": "CA",
"postal_code": "902655746",
"telephone_number": "310-230-4000",
"fax_number": "310-454-1988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICKEL",
"first_name": "BEATA",
"middle_name": "A",
"credential": "MD, PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-24",
"last_updated": "2011-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "CA",
"license": "A51219",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Malibu, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.