Provider Demographics
NPI:1538124300
Name:QURESHI, SAMEER BASHIR (NP)
Entity Type:Individual
Prefix:MR
First Name:SAMEER
Middle Name:BASHIR
Last Name:QURESHI
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 S SAN PEDRO ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013-2101
Mailing Address - Country:US
Mailing Address - Phone:213-673-4849
Mailing Address - Fax:213-673-4581
Practice Address - Street 1:545 S SAN PEDRO ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90013-2101
Practice Address - Country:US
Practice Address - Phone:213-673-4849
Practice Address - Fax:213-673-4581
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP11768363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily