Provider Demographics
NPI:1194024968
Name:NASSRI, RAMEZ S (PA)
Entity Type:Individual
Prefix:MR
First Name:RAMEZ
Middle Name:S
Last Name:NASSRI
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:2537 MOMENTUM PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60689-5325
Mailing Address - Country:US
Mailing Address - Phone:616-988-8227
Mailing Address - Fax:616-285-0846
Practice Address - Street 1:4605 LANKERSHIM BLVD STE 617
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91602-1856
Practice Address - Country:US
Practice Address - Phone:888-447-2362
Practice Address - Fax:888-766-3999
Is Sole Proprietor?:No
Enumeration Date:2011-03-20
Last Update Date:2019-09-04
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Provider Licenses
StateLicense IDTaxonomies
MI5601006010207L00000X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology