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NPI Code Detail

MEDICARE: DR. NADER NASSERI D.D.S.

MEDICARE:  DR. NADER  NASSERI  D.D.S.
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
11223S0112XOral and Maxillofacial Surgery (Dentist)101301CA

General Provider Information

NPI Number : 1811257280
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NADER NASSERI D.D.S.
Provider Business Mailing Address
First Line : 3234 SAWTELLE BLVD APT 308
Second Line :
City : LOS ANGELES
State : CA
Zip : 90066-1617
Country : US
Telephone Number : 971-404-4433
Fax Number :
Provider Business Practice Location Address
First Line : 4200 CHINO HILLS PKWY STE 805
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-3785
Country : US
Telephone Number : 909-606-0160
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2012
Last Update Date : 07/21/2022

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