Healthcare Provider Details

I. General information

NPI: 1427002526
Provider Name (Legal Business Name): MUHAMMAD R NASIR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1403 N FAIR OAKS AVE STE 2
PASADENA CA
91103-1893
US

IV. Provider business mailing address

2052 N LAKE AVE SUITE 2
ALTADENA CA
91001-2450
US

V. Phone/Fax

Practice location:
  • Phone: 626-798-8976
  • Fax: 626-794-3010
Mailing address:
  • Phone: 626-798-8976
  • Fax: 626-794-3010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA044253
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberA044253
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: