Provider Demographics
NPI:1245266618
Name:NOSRATI, SAEID (MD)
Entity type:Individual
Prefix:DR
First Name:SAEID
Middle Name:
Last Name:NOSRATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 31309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-0309
Mailing Address - Country:US
Mailing Address - Phone:323-442-5100
Mailing Address - Fax:
Practice Address - Street 1:1520 SAN PABLO ST
Practice Address - Street 2:SUITE 1000
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-5310
Practice Address - Country:US
Practice Address - Phone:323-442-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG74447207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0016910OtherGROUP MEDICAID PIN
CAW11675OtherGROUP MEDICARE PIN
CA00G744470197OtherCAL OPTIMA
CAW18762OtherGROUP MEDICARE
CA1356390009OtherGROUP NPI
CACE1617OtherGROUP RAILROAD MEDICARE
CA00G744470OtherBLUE SHIELD
CA1902846306OtherGROUP NPI
CAGR0100430OtherGROUP MEDICAL
CA00G744470Medicaid
CA390006771OtherRAILROAD MEDICARE
CAGR0016910OtherGROUP MEDICAID PIN
CAE65623Medicare UPIN