Healthcare Provider Details

I. General information

NPI: 1396872107
Provider Name (Legal Business Name): HANY MORCOS NASR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 05/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W NOBLE AVE
VISALIA CA
93277-2631
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: 559-627-6500
  • Fax: 559-627-6501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberA98792
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: