Provider Demographics
NPI:1073718730
Name:KAISER PERMANENTE
Entity Type:Organization
Organization Name:KAISER PERMANENTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANESTHESIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NAHLA
Authorized Official - Middle Name:MAHER
Authorized Official - Last Name:NASSER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-368-1976
Mailing Address - Street 1:402 GOLDENROD AVE
Mailing Address - Street 2:
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625-2914
Mailing Address - Country:US
Mailing Address - Phone:832-368-1976
Mailing Address - Fax:
Practice Address - Street 1:6670 ALTON PKWY
Practice Address - Street 2:ANESTHESIOLOGY DEPARTMENT 2ND FLOOR
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3734
Practice Address - Country:US
Practice Address - Phone:832-368-1976
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94793282N00000X, 286500000X, 302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
No282N00000XHospitalsGeneral Acute Care Hospital
No286500000XHospitalsMilitary Hospital