Provider Demographics
NPI:1043292030
Name:NAMBIAR, MARGARET MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:MARIE
Last Name:NAMBIAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2390 E FLORIDA AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92544-4755
Mailing Address - Country:US
Mailing Address - Phone:951-652-6100
Mailing Address - Fax:951-929-5333
Practice Address - Street 1:2390 E FLORIDA AVE STE 207
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92544-4755
Practice Address - Country:US
Practice Address - Phone:951-652-6100
Practice Address - Fax:951-658-7548
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-16
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIG620360207W00000X
CAG62036207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G620360Medicaid
CA00G620360Medicare ID - Type Unspecified
CA00G620360Medicaid