| Cyrus Nasserian, M.d. Inc | |
|
415 W Route 66 Suite 202 Glendora CA 91740-4335 | |
| (626) 963-4467 | |
| (626) 963-9543 |
| Full Name | Cyrus Nasserian, M.d. Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 415 W Route 66, Glendora, California |
| Authorized Official Name and Position | Cyrus Nasserian (OWNER/CEO) |
| Authorized Official Contact | 9092791740 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cyrus Nasserian, M.d. Inc Po Box 1770 La Mesa CA 91944-1770 Ph: (619) 464-1165 | Cyrus Nasserian, M.d. Inc 415 W Route 66 Suite 202 Glendora CA 91740-4335 Ph: (626) 963-4467 |
| NPI Number | 1801247721 |
|---|---|
| Provider Enumeration Date | 06/22/2016 |
| Last Update Date | 07/17/2023 |
| Certification Date | 07/17/2023 |
| Medicare PECOS PAC ID | 1052605623 |
|---|---|
| Medicare Enrollment ID | O20160804000111 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801247721 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A122271 (California) | Primary |
| Provider Name | Cyrus Nasserian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154692556 PECOS PAC ID: 8325290943 Enrollment ID: I20121206000174 |
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