Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 0101253439 | VA |
N | 111NI0900X | Internist | 0101253439 | VA |
N | 207R00000X | Internist | A125091 | CA |
N | 111NI0900X | Internist | A125091 | CA |
N | 208D00000X | General Practice Physician | A125091 | CA |
NPI | 1003259870 |
---|---|
Provider Name | Akbar Nassiry |
First Address | Irvine, CA 92604-1713 |
Second Address | Irvine, CA 92604-1713 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2013 |
Last Update Date | 29/05/2020 |