Provider Demographics
NPI:1417959628
Name:KASSAR, NAIM S (MD)
Entity Type:Individual
Prefix:DR
First Name:NAIM
Middle Name:S
Last Name:KASSAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:315 E ROUTE 66
Mailing Address - Street 2:STE 201
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-6257
Mailing Address - Country:US
Mailing Address - Phone:626-963-4124
Mailing Address - Fax:626-963-6773
Practice Address - Street 1:315 E ROUTE 66
Practice Address - Street 2:STE 201
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-6257
Practice Address - Country:US
Practice Address - Phone:626-963-4124
Practice Address - Fax:626-963-6773
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2024-02-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC41008207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00LC410080Medicaid
CAWC41008AMedicare ID - Type Unspecified
CA00LC410080Medicaid