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General NPI Number Information
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NPI Number | 1205191038
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Entity Type | Individual
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Provider Name | NASIR AWAN
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Gender | Male
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Dates
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Enumeration Date | 07/09/2012
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Last Update Date | 07/11/2012
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Provider Practice Location Address
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Address Line | 7816 YORKTOWN PLACE
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City | LOS ANGELES
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State | CA
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Zip | 90045
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Country | US
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Telephone | 310-902-7741
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Fax | 310-568-0547
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Provider Business Mailing Address
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Address Line | 7816 YORKTOWN PLACE
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City | LOS ANGELES
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State | CA
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Zip | 90045
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Country | US
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Telephone | 310-902-7741
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Fax | 310-568-0547
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0000450042-00024
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 0000450042-00024
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License Number State | CA
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