MEDICARE: DR. JOHN ALAN NASTRO M.D.

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	207R00000X	Internal Medicine Physician	G20705	CA
2	207RP1001X	Pulmonary Disease Physician	G207050	CA

General Provider Information

NPI Number	:	1770856817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN ALAN NASTRO M.D.

Provider Business Mailing Address
First Line	:	945 MANNING AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-3218
Country	:	US
Telephone Number	:	310-927-7132
Fax Number	:	910-776-7479

Provider Business Practice Location Address
First Line	:	945 MANNING AVENUE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-3218
Country	:	US
Telephone Number	:	310-927-7132
Fax Number	:	910-776-7479

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

Provider Enumeration Date	:	02/21/2012
Last Update Date	:	02/21/2012

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