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NPI Code Detail

MEDICARE: DR. PETER THEODORE NASSAR M.D.

MEDICARE: DR. PETER THEODORE NASSAR M.D.
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
1207V00000XObstetrics & Gynecology PhysicianA80372CA

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 : 1669498622
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETER THEODORE NASSAR M.D.
Provider Business Mailing Address
First Line : 6121 N THESTA ST
Second Line : SUITE 303
City : FRESNO
State : CA
Zip : 93710-8603
Country : US
Telephone Number : 559-450-2300
Fax Number : 559-450-2392
Provider Business Practice Location Address
First Line : 1303 E HERNDON AVE
Second Line :
City : FRESNO
State : CA
Zip : 93720-3309
Country : US
Telephone Number : 559-450-3000
Fax Number : 559-450-7472
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2006
Last Update Date : 04/06/2026

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