Healthcare Provider Details

I. General information

NPI: 1174090856
Provider Name (Legal Business Name): VITALITY INTEGRATIVE PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2018
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 BARRANCA PKWY STE 250
IRVINE CA
92604-1713
US

IV. Provider business mailing address

4000 BARRANCA PKWY STE 250
IRVINE CA
92604-1713
US

V. Phone/Fax

Practice location:
  • Phone: 323-451-2825
  • Fax: 714-389-3140
Mailing address:
  • Phone: 323-451-2825
  • Fax: 714-389-3140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: AKBAR NASSIRY
Title or Position: PRESIDENT/MEDICAL DIRECTOR
Credential: MD, MPH
Phone: 323-451-2825