| Mohamed Nassar M.D. | |
|
255 Terracina Blvd Ste 105 Redlands CA 92373-4870 | |
| (909) 793-6526 | |
| Not Available |
| Full Name | Mohamed Nassar M.D. |
|---|---|
| Speciality | Internal Medicine |
| Location | 255 Terracina Blvd Ste 105, Redlands, California |
| Authorized Official Name and Position | Mohamed Nassar (DIRECTOR) |
| Authorized Official Contact | 9097930323 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mohamed Nassar M.D. 255 Terracina Blvd Ste 105 Redlands CA 92373-4870 Ph: (909) 793-0323 | Mohamed Nassar M.D. 255 Terracina Blvd Ste 105 Redlands CA 92373-4870 Ph: (909) 793-6526 |
| NPI Number | 1992342539 |
|---|---|
| Provider Enumeration Date | 12/03/2019 |
| Last Update Date | 03/13/2020 |
| Certification Date | 03/13/2020 |
| Medicare PECOS PAC ID | 2365871522 |
|---|---|
| Medicare Enrollment ID | O20200409000916 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992342539 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (NU) | Primary |
| Provider Name | Michael Anthony Estrada |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1275517617 PECOS PAC ID: 1658262753 Enrollment ID: I20040319001596 |
| Provider Name | Annette Minicucci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710374178 PECOS PAC ID: 6507166543 Enrollment ID: I20151124001676 |
| Provider Name | Mohamed Nassar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346545043 PECOS PAC ID: 0749459550 Enrollment ID: I20200128001223 |
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