Healthcare Provider Details

I. General information

NPI: 1558386367
Provider Name (Legal Business Name): ANDREW F NASSERI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9888 GENESEE AVE
LA JOLLA CA
92037-1205
US

IV. Provider business mailing address

1150 CRESTHILL PL
EL CAJON CA
92021-3303
US

V. Phone/Fax

Practice location:
  • Phone: 209-222-0801
  • Fax:
Mailing address:
  • Phone: 209-222-0801
  • Fax: 619-938-3232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA94125
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberV3058
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberA94125
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: