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NPI Code Detail

MEDICARE: DAVID C NAZEMI MD

MEDICARE: DAVID C NAZEMI MD
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
1207R00000XInternal Medicine Physician216885MA
2207R00000XInternal Medicine PhysicianMD26621OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1457329286
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID C NAZEMI MD
Provider Business Mailing Address
First Line : 12117 SW 18TH AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97219-7766
Country : US
Telephone Number : 971-255-1001
Fax Number :
Provider Business Practice Location Address
First Line : 19300 SW 65TH AVE
Second Line :
City : TUALATIN
State : OR
Zip : 97062-7706
Country : US
Telephone Number : 503-692-1212
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2006
Last Update Date : 07/08/2007

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Directions to “ DAVID C NAZEMI MD” Practice Location

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