Provider Demographics
NPI:1225164999
Name:NASSIRI, JAMES A (MD, MA)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:NASSIRI
Suffix:
Gender:M
Credentials:MD, MA
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Mailing Address - Street 1:225 S LAKE AVE STE 535
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-3010
Mailing Address - Country:US
Mailing Address - Phone:626-795-6596
Mailing Address - Fax:626-795-8247
Practice Address - Street 1:1420 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-2508
Practice Address - Country:US
Practice Address - Phone:818-502-1900
Practice Address - Fax:818-502-4738
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2010-01-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA86743207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A867430OtherBLUE SHIELD
CAAX464ZMedicare PIN
CAAX464YMedicare PIN