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General NPI Number Information
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NPI Number | 1497044465
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Entity Type | Individual
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Provider Name | KARMIN P NISSAN MD
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Gender | Male
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Dates
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Enumeration Date | 03/30/2011
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Last Update Date | 12/30/2021
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Provider Practice Location Address
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Address Line | 25186 HANCOCK AVE STE 200
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City | MURRIETA
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State | CA
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Zip | 92562-5998
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Country | US
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Telephone | 951-414-3484
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Fax | 949-561-5404
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Provider Business Mailing Address
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Address Line | 25186 HANCOCK AVE
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City | MURRIETA
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State | CA
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Zip | 92562-5998
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Country | US
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Telephone | 951-414-3484
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Fax | 949-561-5404
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A144993
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | A144993
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License Number State | CA
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