Individual
NAGUI NABIL SOROUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
999 S FAIRMONT AVE #100, LODI, LODI, CA 95240
(209) 334-2010
(209) 334-0132
Mailing address
999 S FAIRMONT AVE #100, LODI, CA 95240
(209) 334-2010
(209) 334-0132
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
A312100
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A312100
—
CA
01
—
0200005210
RAILROAD MEDICARE
CA
01
—
942658928
COMMERICAL INSURANCE
CA
Enumeration date
11/01/2006
Last updated
02/26/2013
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