MEDICARE: M Y NASIR MD INC

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
1	207Q00000X	Family Medicine Physician	G1042-P	CA

General Provider Information

NPI Number	:	1356445639
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M Y NASIR MD INC

Provider Business Mailing Address
First Line	:	500 N GARFIELD AVE
Second Line	:	#110
City	:	MONTEREY PARK
State	:	CA
Zip	:	91754-1274
Country	:	US
Telephone Number	:	626-288-8900
Fax Number	:	626-288-2466

Provider Business Practice Location Address
First Line	:	500 N GARFIELD AVE
Second Line	:	#110
City	:	MONTEREY PARK
State	:	CA
Zip	:	91754-1274
Country	:	US
Telephone Number	:	626-288-8900
Fax Number	:	626-288-2466

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MUSA Y NASIR
Credential	:	MD
Telephone Number	:	626-288-8900

Provider Enumeration Date	:	09/08/2006
Last Update Date	:	10/14/2008

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