1295702843 NPI number — DR. FRANK CARL NASTANSKI M.D.

Table of content: DR. FRANK CARL NASTANSKI M.D. (NPI 1295702843)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295702843 NPI number — DR. FRANK CARL NASTANSKI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NASTANSKI
Provider First Name:
FRANK
Provider Middle Name:
CARL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NASTANSKI
Provider Other First Name:
FRANK
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1295702843
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/07/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
999 N TUSTIN AVE STE 109
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANTA ANA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92705-6501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-547-1915
Provider Business Mailing Address Fax Number:
714-547-6552

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
999 N TUSTIN AVE
Provider Second Line Business Practice Location Address:
SUITE 116
Provider Business Practice Location Address City Name:
SANTA ANA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92705-3528
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-547-1915
Provider Business Practice Location Address Fax Number:
714-547-6552
Provider Enumeration Date:
03/02/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2086S0127X , with the licence number:  A68851 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: A68851 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)