Healthcare Provider Details

I. General information

NPI: 1104123892
Provider Name (Legal Business Name): HANY NASR MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2011
Last Update Date: 01/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E NOBLE AVE
VISALIA CA
93277-2857
US

IV. Provider business mailing address

PO BOX 3500
VISALIA CA
93278-3500
US

V. Phone/Fax

Practice location:
  • Phone: 559-627-6500
  • Fax: 559-627-6501
Mailing address:
  • Phone: 559-308-3905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: HANY M NASR
Title or Position: OWNER
Credential: MD
Phone: 559-308-3905