| Doctor Name: | DR. JOHN LOUIS NICHOLSON |
| NPI Number: | 1023176625 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | |
| Business Practice Address: | 715 Altos Oaks Dr Los Altos, CA - 940245402 |
| Business Phone Number: | 6509484730 |
| Business Fax Number: | 6509484732 |
| Mailing Address: | 715 Altos Oaks Dr, LOS ALTOS |
| State: | CA |
| Postal Code: | 940245402 |
| Phone Number: | 6509484730 |
| Fax Number: | 6509484732 |
| NPI Enumeration Date: | 12/05/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |