Active NPI
Nicole B Mulder, MD
- Ophthalmology Physician
- Escondido, CA
National Provider Identifier
1356373567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- A75895
- Practice address
- 810 East Ohio Ave
Escondido, CA 92025-3421 - Phone
- (760) 746-3937
- Fax
- (760) 746-3991
- NPI assigned
- Jul 7, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | A75895 | CA | Primary |
Addresses
Primary practice location
810 East Ohio Ave
Escondido, CA 92025-3421
Mailing address
810 East Ohio Ave
Escondido, CA 92025-3421
Phone (760) 746-3937
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A758950 | Medicaid | CA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75895 | CA | MD | Clinical Social Worker |
| A75895 | CA | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356373567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "810 EAST OHIO AVE",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920253421",
"telephone_number": "760-746-3937",
"fax_number": "760-746-3991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 EAST OHIO AVE",
"city": "ESCONDIDO",
"state": "CA",
"postal_code": "920253421",
"telephone_number": "760-746-3937",
"fax_number": "760-746-3991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULDER",
"first_name": "NICOLE",
"middle_name": "B",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "CA",
"license": "A75895",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A758950",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Escondido, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.