Provider Demographics
NPI:1265545321
Name:ANEES, NASR N (MD)
Entity type:Individual
Prefix:
First Name:NASR
Middle Name:N
Last Name:ANEES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1040 FLYNN RD
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-5092
Mailing Address - Country:US
Mailing Address - Phone:805-673-3930
Mailing Address - Fax:805-659-3217
Practice Address - Street 1:355 CENTRAL AVENUE
Practice Address - Street 2:CLINICAS DEL CAMINO REAL, INC
Practice Address - City:FILLMORE
Practice Address - State:CA
Practice Address - Zip Code:93015
Practice Address - Country:US
Practice Address - Phone:805-524-4926
Practice Address - Fax:805-524-4137
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA52690207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A526900Medicaid
F98856Medicare UPIN
W3731BMedicare ID - Type Unspecified