MEDICARE: OBTEEN N NASSIRI D.C.

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	111N00000X	Chiropractor	B-847	NV

General Provider Information

NPI Number	:	1346579034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OBTEEN N NASSIRI D.C.

Provider Business Mailing Address
First Line	:	2100 S MARYLAND PKWY
Second Line	:	#8
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-3225
Country	:	US
Telephone Number	:	702-732-2273
Fax Number	:	702-732-2173

Provider Business Practice Location Address
First Line	:	2100 S MARYLAND PKWY
Second Line	:	#8
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-3225
Country	:	US
Telephone Number	:	702-732-2273
Fax Number	:	702-732-2173

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

Provider Enumeration Date	:	12/09/2009
Last Update Date	:	12/09/2009

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