Provider Demographics
NPI:1164059135
Name:NICULESCU, ALEXANDER BRYCE WILLIAMS (MD)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:BRYCE WILLIAMS
Last Name:NICULESCU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 N LARCHMONT BLVD # 145
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-3011
Mailing Address - Country:US
Mailing Address - Phone:202-320-5864
Mailing Address - Fax:
Practice Address - Street 1:2021 SANTA MONICA BLVD STE 245E
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2132
Practice Address - Country:US
Practice Address - Phone:310-829-8975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA187471207R00000X, 207RH0002X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine