Healthcare Provider Details

I. General information

NPI: 1073804761
Provider Name (Legal Business Name): HADI NASSAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2011
Last Update Date: 01/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 W ANAPAMU ST STE 420
SANTA BARBARA CA
93101-3107
US

IV. Provider business mailing address

27 W ANAPAMU ST STE 420
SANTA BARBARA CA
93101-3107
US

V. Phone/Fax

Practice location:
  • Phone: 805-448-7277
  • Fax:
Mailing address:
  • Phone: 805-448-7277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License Number1723
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number60115
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: