Provider Demographics
NPI:1174623920
Name:NASIM, SOHAIL (MD)
Entity type:Individual
Prefix:
First Name:SOHAIL
Middle Name:
Last Name:NASIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 77790
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92877-0126
Mailing Address - Country:US
Mailing Address - Phone:951-278-5590
Mailing Address - Fax:951-272-9924
Practice Address - Street 1:7230 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 302
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1907
Practice Address - Country:US
Practice Address - Phone:818-227-4272
Practice Address - Fax:818-227-4271
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA63319207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1174623920Medicaid
CAH46675Medicare UPIN
CA1174623920Medicaid