Provider Demographics
NPI:1790232783
Name:EL-NIMRI, NEVIN W (OD, PHD, FAAO)
Entity Type:Individual
Prefix:DR
First Name:NEVIN
Middle Name:W
Last Name:EL-NIMRI
Suffix:
Gender:F
Credentials:OD, PHD, FAAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9415 CAMPUS POINT DR
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92093-1350
Mailing Address - Country:US
Mailing Address - Phone:858-534-6290
Mailing Address - Fax:
Practice Address - Street 1:9415 CAMPUS POINT DR
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92093-3219
Practice Address - Country:US
Practice Address - Phone:858-534-6290
Practice Address - Fax:858-534-9705
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT15150152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist