Provider Demographics
NPI:1437730876
Name:NAIR, TANUSHREE (DO)
Entity type:Individual
Prefix:
First Name:TANUSHREE
Middle Name:
Last Name:NAIR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2995 RED HILL AVE
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-5976
Mailing Address - Country:US
Mailing Address - Phone:949-763-7188
Mailing Address - Fax:
Practice Address - Street 1:26671 ALISO CREEK RD
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-4809
Practice Address - Country:US
Practice Address - Phone:949-791-3104
Practice Address - Fax:949-791-3181
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-17
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A22437207Q00000X
IL125077432207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine