Provider Demographics
NPI:1467764795
Name:NASSERIAN, FARIDEH Z (MD)
Entity Type:Individual
Prefix:DR
First Name:FARIDEH
Middle Name:Z
Last Name:NASSERIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 VIA CORONEL
Mailing Address - Street 2:
Mailing Address - City:PALOS VERDES ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-1952
Mailing Address - Country:US
Mailing Address - Phone:310-465-0660
Mailing Address - Fax:
Practice Address - Street 1:1215 VIA CORONEL
Practice Address - Street 2:
Practice Address - City:PALOS VERDES ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-1952
Practice Address - Country:US
Practice Address - Phone:310-465-0660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41146207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine