Provider Demographics
NPI:1588799183
Name:NINA M PASIN, OD, LLC
Entity Type:Organization
Organization Name:NINA M PASIN, OD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NINA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:PASIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:907-522-9113
Mailing Address - Street 1:800 E DIMOND BLVD
Mailing Address - Street 2:#3-138
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-2061
Mailing Address - Country:US
Mailing Address - Phone:907-522-9113
Mailing Address - Fax:907-522-9557
Practice Address - Street 1:800 E DIMOND BLVD
Practice Address - Street 2:#3-138
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-2061
Practice Address - Country:US
Practice Address - Phone:907-522-9113
Practice Address - Fax:907-522-9557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK177152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKOD47191Medicaid
AKOD47191Medicaid