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NPI Code Detail

MEDICARE: DR. HAMID REZA NASSERI DO.

MEDICARE: DR. HAMID REZA NASSERI DO.
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
1207R00000XInternal Medicine Physician20A11370CA
2207RP1001XPulmonary Disease Physician20A11370CA

General Provider Information

NPI Number : 1922298371
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HAMID REZA NASSERI DO.
Provider Business Mailing Address
First Line : 3769 BEVERLY RIDGE
Second Line :
City : SHERMAN OAKS
State : CA
Zip : 91423
Country : US
Telephone Number : 818-399-1838
Fax Number :
Provider Business Practice Location Address
First Line : 1 MEDICAL CENTER DR
Second Line :
City : STRATFORD
State : NJ
Zip : 08084-1500
Country : US
Telephone Number : 856-566-2753
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2007
Last Update Date : 09/18/2012

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