Provider Demographics
NPI:1972668416
Name:NASSER, SUSAN MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:MARIE
Last Name:NASSER
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:42135 10TH ST W
Mailing Address - Street 2:STE 201
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-6093
Mailing Address - Country:US
Mailing Address - Phone:661-945-2221
Mailing Address - Fax:661-945-0831
Practice Address - Street 1:1523 W AVENUE J
Practice Address - Street 2:STE 7
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2819
Practice Address - Country:US
Practice Address - Phone:661-945-2221
Practice Address - Fax:661-945-0831
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2019-11-04
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Provider Licenses
StateLicense IDTaxonomies
CA20A8970207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine