Healthcare Provider Details

I. General information

NPI: 1669498622
Provider Name (Legal Business Name): PETER THEODORE NASSAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7202 N MILLBROOK AVE STE 206
FRESNO CA
93720-3341
US

IV. Provider business mailing address

6121 N THESTA ST SUITE 303
FRESNO CA
93710-8603
US

V. Phone/Fax

Practice location:
  • Phone: 559-450-2300
  • Fax: 559-450-2392
Mailing address:
  • Phone: 559-450-2300
  • Fax: 559-450-2392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA80372
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: