Provider Demographics
NPI:1154615565
Name:NASSERI, MORAD (MD)
Entity type:Individual
Prefix:DR
First Name:MORAD
Middle Name:
Last Name:NASSERI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:MORAD
Other - Middle Name:
Other - Last Name:NASSERI NOWSAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 888584
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90088-8584
Mailing Address - Country:US
Mailing Address - Phone:925-691-9806
Mailing Address - Fax:925-691-9807
Practice Address - Street 1:450 N WIGET LN
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2408
Practice Address - Country:US
Practice Address - Phone:925-691-9806
Practice Address - Fax:925-691-9807
Is Sole Proprietor?:No
Enumeration Date:2011-06-02
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA172982208VP0014X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine