Healthcare Provider Details

I. General information

NPI: 1821324666
Provider Name (Legal Business Name): PAUL NASSIF MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2009
Last Update Date: 12/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 S SPALDING DR STE 315
BEVERLY HILLS CA
90212-1836
US

IV. Provider business mailing address

120 S SPALDING DR STE 315
BEVERLY HILLS CA
90212-1836
US

V. Phone/Fax

Practice location:
  • Phone: 310-275-2467
  • Fax: 310-275-6651
Mailing address:
  • Phone: 310-275-2467
  • Fax: 310-275-6651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberG84590
License Number StateCA

VIII. Authorized Official

Name: DR. PAUL S. NASSIF
Title or Position: OWNER
Credential: M.D
Phone: 310-275-2467