Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nicole Izetta Bostic, MD

Individual provider Pediatrics Physician · NPI 1417159161

Nicole Izetta Bostic, MD is a Pediatrics Physician in Riverside, California. Practices as a sole proprietor. Licensed in California and Missouri.

Licensed in
CA, MO
In the registry since
2007
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

9041 Magnolia Ave Ste 305
Riverside, CA 92503-3900
Phone: (951) 343-3481
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence C55464 (CA)
Pediatrics Physician Taxonomy 208000000X · Licence 2007018726 (MO)

Record details

NPI number1417159161
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedJune 4, 2007
Last updated in NPPESMarch 18, 2015

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