Provider Demographics
NPI:1316103799
Name:NAGHSHINEH, NIMA (MD)
Entity type:Individual
Prefix:DR
First Name:NIMA
Middle Name:
Last Name:NAGHSHINEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 ALESSANDRO PL STE 400
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3179
Mailing Address - Country:US
Mailing Address - Phone:626-696-8181
Mailing Address - Fax:626-424-2121
Practice Address - Street 1:50 ALESSANDRO PL STE 400
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3179
Practice Address - Country:US
Practice Address - Phone:626-696-8181
Practice Address - Fax:626-424-2121
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA141766174400000X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA141766OtherMEDICAL LIC