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NPI Code Detail

MEDICARE: DR. NASIM PEDARSANI OD

MEDICARE: DR. NASIM PEDARSANI OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOPT 13424TCA

General Provider Information

NPI Number : 1306916978
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NASIM PEDARSANI OD
Provider Business Mailing Address
First Line : 18649 VIA PRINCESSA
Second Line :
City : SANTA CLARITA
State : CA
Zip : 91387-4935
Country : US
Telephone Number : 773-459-6192
Fax Number :
Provider Business Practice Location Address
First Line : 18649 VIA PRINCESSA
Second Line :
City : SANTA CLARITA
State : CA
Zip : 91387-4935
Country : US
Telephone Number : 773-459-6192
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2006
Last Update Date : 09/22/2010

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