Provider Demographics
NPI:1750261863
Name:RAPOZA, NICHOLAS KEVIN
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:KEVIN
Last Name:RAPOZA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21222 DOVE CIR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-7246
Mailing Address - Country:US
Mailing Address - Phone:714-369-4316
Mailing Address - Fax:
Practice Address - Street 1:21222 DOVE CIR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92646-7246
Practice Address - Country:US
Practice Address - Phone:714-369-4316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty