Provider Demographics
NPI:1558939132
Name:NASIR, FAREEHA (MD)
Entity type:Individual
Prefix:
First Name:FAREEHA
Middle Name:
Last Name:NASIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1278 E LATHAM AVE
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-4445
Mailing Address - Country:US
Mailing Address - Phone:951-925-6625
Mailing Address - Fax:
Practice Address - Street 1:1278 E LATHAM AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4445
Practice Address - Country:US
Practice Address - Phone:951-925-6625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-11
Last Update Date:2025-01-08
Deactivation Date:2022-12-01
Deactivation Code:
Reactivation Date:2024-02-13
Provider Licenses
StateLicense IDTaxonomies
CAA195554207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine