MEDICARE: REMA NAIR NP

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	363LF0000X	Family Nurse Practitioner	NP95002198	CA
2	363LW0102X	Women's Health Nurse Practitioner	NP95002198	CA

General Provider Information

NPI Number	:	1881081966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REMA NAIR NP

Provider Business Mailing Address
First Line	:	1351 MITCHELL AVE
Second Line	:
City	:	TUSTIN
State	:	CA
Zip	:	92780-5745
Country	:	US
Telephone Number	:	714-402-9368
Fax Number	:

Provider Business Practice Location Address
First Line	:	1351 MITCHELL AVE
Second Line	:
City	:	TUSTIN
State	:	CA
Zip	:	92780-5745
Country	:	US
Telephone Number	:	714-402-9368
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2015
Last Update Date	:	04/16/2015

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