Provider Demographics
NPI:1568798296
Name:AMIR G NASSERI, MD, PC
Entity Type:Organization
Organization Name:AMIR G NASSERI, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:G
Authorized Official - Last Name:NASSERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-387-3801
Mailing Address - Street 1:1155 W CENTRAL AVE
Mailing Address - Street 2:SUITE 214
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92707-3165
Mailing Address - Country:US
Mailing Address - Phone:714-966-9094
Mailing Address - Fax:
Practice Address - Street 1:1155 W CENTRAL AVE
Practice Address - Street 2:SUITE 214
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92707-3165
Practice Address - Country:US
Practice Address - Phone:714-966-9094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-31
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty