Provider Demographics
NPI:1659366334
Name:LESSANI, NASI DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:NASI
Middle Name:DAVID
Last Name:LESSANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:N
Other - Middle Name:DAVID
Other - Last Name:LESSANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:319 CHURCH STREET
Mailing Address - Street 2:
Mailing Address - City:HALF MOON BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94019
Mailing Address - Country:US
Mailing Address - Phone:650-712-9411
Mailing Address - Fax:650-712-9511
Practice Address - Street 1:319 CHURCH STREET
Practice Address - Street 2:
Practice Address - City:HALF MOON BAY
Practice Address - State:CA
Practice Address - Zip Code:94019
Practice Address - Country:US
Practice Address - Phone:650-712-9411
Practice Address - Fax:650-712-9511
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC37680207VG0400X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
B43038Medicare UPIN
00C376800Medicare ID - Type Unspecified