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General NPI Number Information
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NPI Number | 1629295845
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Entity Type | Individual
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Provider Name | SHAWN NASSERI MD
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Gender | Male
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 435 N BEDFORD DR SUITE 203
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4321
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Country | US
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Telephone | 310-289-8200
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Fax | 310-289-8205
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Provider Business Mailing Address
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Address Line | 9663 SANTA MONICA BLVD # 788
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4303
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Country | US
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Telephone | 310-729-3116
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Fax | 310-289-8205
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | A71218
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License Number State | CA
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