Provider Demographics
NPI:1649454638
Name:NASREEN, TANZINA (MD)
Entity type:Individual
Prefix:MS
First Name:TANZINA
Middle Name:
Last Name:NASREEN
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:PO BOX 1127
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-1127
Mailing Address - Country:US
Mailing Address - Phone:562-596-1667
Mailing Address - Fax:562-598-6867
Practice Address - Street 1:10941 BLOOMFIELD ST
Practice Address - Street 2:SUITE A
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-2530
Practice Address - Country:US
Practice Address - Phone:562-596-1667
Practice Address - Fax:562-598-6867
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA92620207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology