Provider Demographics
NPI:1003259870
Name:NASSIRY, AKBAR (MD, MPH)
Entity Type:Individual
Prefix:
First Name:AKBAR
Middle Name:
Last Name:NASSIRY
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 BARRANCA PARKWAY
Mailing Address - Street 2:STE. 250
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-1713
Mailing Address - Country:US
Mailing Address - Phone:949-577-0047
Mailing Address - Fax:909-635-6085
Practice Address - Street 1:4000 BARRANCA PARKWAY
Practice Address - Street 2:STE. 250
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-1713
Practice Address - Country:US
Practice Address - Phone:949-577-0047
Practice Address - Fax:909-635-6085
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-11
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA125091207R00000X, 208D00000X, 208M00000X
VA0101253439207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty