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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

NICOLE KOULISIS, MD

Active

NICOLE KOULISIS, MD is a Sports Medicine (Emergency) healthcare provider located in ENCINO, California. NPI 1073033213 is currently active in the NPPES registry. Verify at CMS.

Sports Medicine (Emergency) · ENCINO, CA

Registration Details

NPI Number
1073033213
Provider Type
Individual
Gender
Female
NPI Issued
Jun 20, 2017 (9.1912113526811 yrs)
Last Updated
Dec 1, 2022
Licenses
A157849 (CA)
A157849 (CA)

Practice Information

Address
5400 BALBOA BLVD STE 126
ENCINO, CA, 913165202
Browse CA providers · Browse ZIP 91316
Phone
8185780004
Fax
8185780002
Primary Specialty
Sports Medicine (Emergency)
207WX0107X
Additional Specialty
Sports Medicine (Emergency)

Other Sports Medicine (Emergency) Providers in ENCINO, CA

Name Credential NPI
DR. CHRISTIAN JAMES SANFILIPPO M.D. 1851653547
DR. STAVROS N. MOYSIDIS M.D. 1780023929
JESSICA LELY CAO 1417301227
DR. ERIC JUNG MD 1740749076
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.