Provider Demographics
NPI:1770589293
Name:AL-NASER, RAED A (MD)
Entity type:Individual
Prefix:
First Name:RAED
Middle Name:A
Last Name:AL-NASER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2535
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91943-2535
Mailing Address - Country:US
Mailing Address - Phone:888-664-8297
Mailing Address - Fax:866-313-8916
Practice Address - Street 1:5525 GROSSMONT CENTER DR STE 609
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3009
Practice Address - Country:US
Practice Address - Phone:619-589-9158
Practice Address - Fax:619-462-0371
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA71932207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA71932BMedicare PIN
CAH12522Medicare UPIN