MEDICARE: MR. NORMAN CHARLES NASISE 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
1	207V00000X	Obstetrics & Gynecology Physician	A36977	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1902807951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NORMAN CHARLES NASISE MD

Provider Business Mailing Address
First Line	:	2526 SISTER MARY COLUMBA DR
Second Line	:
City	:	RED BLUFF
State	:	CA
Zip	:	96080-4327
Country	:	US
Telephone Number	:	530-529-0091
Fax Number	:	530-529-5149

Provider Business Practice Location Address
First Line	:	2526 SISTER MARY COLUMBA DR
Second Line	:
City	:	RED BLUFF
State	:	CA
Zip	:	96080-4327
Country	:	US
Telephone Number	:	530-529-0091
Fax Number	:	530-529-5149

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

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	07/08/2007

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