Doctor Name: | SAMIR AK NAZO |
NPI Number: | 1538146840 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | A38614 |
Business Practice Address: | 2307 W Empire Ave Burbank, CA - 915043318 |
Business Phone Number: | 8188413420 |
Business Fax Number: | 8188415171 |
Mailing Address: | 2307 W Empire Ave, BURBANK |
State: | CA |
Postal Code: | 915043318 |
Phone Number: | 8188413420 |
Fax Number: | 8188415171 |
NPI Enumeration Date: | 12/28/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A38614 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |