Provider Demographics
NPI:1114008067
Name:TEJANI, NASIR (MD)
Entity Type:Individual
Prefix:
First Name:NASIR
Middle Name:
Last Name:TEJANI
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 1:711 PEPPERTREE LANE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815
Mailing Address - Country:US
Mailing Address - Phone:562-421-8283
Mailing Address - Fax:562-420-9092
Practice Address - Street 1:711 PEPPER TREE LN
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-4731
Practice Address - Country:US
Practice Address - Phone:562-421-8283
Practice Address - Fax:562-420-9092
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA32473208M00000X, 2080A0000X, 2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine