Provider Demographics
NPI:1427002526
Name:NASIR, MUHAMMAD R (MD)
Entity Type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:R
Last Name:NASIR
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 1:2052 N LAKE AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-2450
Mailing Address - Country:US
Mailing Address - Phone:626-798-8976
Mailing Address - Fax:626-794-3010
Practice Address - Street 1:1403 N FAIR OAKS AVE STE 2
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-1893
Practice Address - Country:US
Practice Address - Phone:626-798-8976
Practice Address - Fax:626-794-3010
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA044253208VP0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA356624900OtherOWCP
CA00A442532Medicaid
CA412053145OtherCALIFORNIA BLUE CROSS
CA00A442530AMedicaid
CA00A442530OtherCALIFORNIA BLUE SHIELD
CAWA44253AMedicare ID - Type UnspecifiedMEDICARE PPIN
CAWA44253BMedicare PIN
CAE42999Medicare UPIN