Individual provider Active NPI

Galina Vladimirovna Nikolskaya, M.D.

  • Neurology Physician
  • San Diego, CA
National Provider Identifier
1457620965
Registry record updated Dec 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A119235 Issued in CA
Practice address
200 W Arbor Dr
8465
San Diego, CA 92103-9000
Phone
(619) 543-3500
Fax
(619) 543-6806
NPI assigned
Dec 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X A119235 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
8465
San Diego, CA 92103-9000

Mailing address

200 W Arbor Dr
8465
San Diego, CA 92103-9000
Phone (619) 543-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170417001952 CA Practitioner - Neurology 2567748015 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A119235CAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sirius Imaging Inc CurrentSince Jul 23, 2020 Accepting new patients
County of Los Angeles CurrentSince Jun 20, 2017 Accepting new patients
County of Los Angeles CurrentSince Jun 20, 2017 Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

1000 W Carson St
Torrance, CA 90502
Phone (310) 222-3501

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1325116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325116800000",
    "number": "1457620965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "address_2": "8465",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "619-543-3500",
            "fax_number": "619-543-6806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "address_2": "8465",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921039000",
            "telephone_number": "619-543-3500",
            "fax_number": "619-543-6806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKOLSKAYA",
        "first_name": "GALINA",
        "middle_name": "VLADIMIROVNA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-29",
        "last_updated": "2011-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A119235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.