Provider Demographics
NPI:1295702843
Name:NASTANSKI, FRANK CARL (MD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:CARL
Last Name:NASTANSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:FRANK
Other - Middle Name:
Other - Last Name:NASTANSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:999 N TUSTIN AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-6501
Mailing Address - Country:US
Mailing Address - Phone:714-547-1915
Mailing Address - Fax:714-547-6552
Practice Address - Street 1:999 N TUSTIN AVE
Practice Address - Street 2:SUITE 116
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3528
Practice Address - Country:US
Practice Address - Phone:714-547-1915
Practice Address - Fax:714-547-6552
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-02
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA688512086S0127X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH78379Medicare UPIN