Provider Demographics
NPI:1023993318
Name:NEUROSPINE MD
Entity type:Organization
Organization Name:NEUROSPINE MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FAHIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:NASAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:725-502-1061
Mailing Address - Street 1:175 W LEXINGTON AVE STE B
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-4454
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:175 W LEXINGTON AVE STE B
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-4454
Practice Address - Country:US
Practice Address - Phone:725-502-1061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury MedicineGroup - Multi-Specialty