Provider Demographics
NPI:1366294209
Name:NAZARALI, SAMIR (MD)
Entity type:Individual
Prefix:DR
First Name:SAMIR
Middle Name:
Last Name:NAZARALI
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 1:850 HEALTH SCIENCES RD, 3RD FLOOR, MAILROOM
Mailing Address - Street 2:NATALLY ALVARADO- GAVIN HERBERT EYE INSTITUTE
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92617
Mailing Address - Country:US
Mailing Address - Phone:949-824-7105
Mailing Address - Fax:
Practice Address - Street 1:101 THE CITY DR S
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3298
Practice Address - Country:US
Practice Address - Phone:714-456-7890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA194657207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology