MEDICARE: AARTI MANOHAR NASTA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	A91065	CA

General Provider Information

NPI Number	:	1346447893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARTI MANOHAR NASTA MD

Provider Business Mailing Address
First Line	:	415 TESCONI CIR
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95401-4619
Country	:	US
Telephone Number	:	707-578-1175
Fax Number	:	707-578-1147

Provider Business Practice Location Address
First Line	:	401 WARREN ST
Second Line	:	SUITE 302
City	:	REDWOOD CITY
State	:	CA
Zip	:	94063-1578
Country	:	US
Telephone Number	:	650-701-1882
Fax Number	:	650-701-1886

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2007
Last Update Date	:	07/23/2013

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