Fred Zachary Nour, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

C54401 Issued in CA

Practice address

26691 Plaza
Ste 235
Mission Viejo, CA 92691-6329

Phone

(949) 364-9054

Fax

(949) 364-6171

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Farid Zaky Khellah Nour Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1753

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Caduceus Physicians Medical Group

  • Family Medicine Physician
  • Yorba Linda, CA
  • NPI 1497702724
  NPD (past)
• Cedars Towers Surgical Medical Group

  • Surgery Physician
  • Los Angeles, CA
  • NPI 1881633287
  NPD (past)
• Santa Ana Clinica Medica General Medical Center Inc.

  • Multi-Specialty Clinic/Center
  • Santa Ana, CA
  • NPI 1104873686
  NPD (past)
• Josephson-Wallack-Munshower Neurology PC

  dba JWM Neurology PC

  • Neurology Physician
  • Indianapolis, IN
  • NPI 1740377803
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355097600000",
    "number": "1881629350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26691 PLAZA",
            "address_2": "STE 235",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916329",
            "telephone_number": "949-364-9054",
            "fax_number": "949-364-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26691 PLAZA",
            "address_2": "STE 235",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916329",
            "telephone_number": "949-364-9054",
            "fax_number": "949-364-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOUR",
        "first_name": "FRED",
        "middle_name": "ZACHARY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2012-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "C54401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036065960",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000502077",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2201682",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200846240",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FARID",
            "last_name": "NOUR",
            "middle_name": "ZAKY KHELLAH",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sophia Elisabeth Norheim, LMFT
• Michelle R Noriega
• Norya Inc
• Sam Nosrati, DPM
• Nour Wellness Group LLC
• Homa Sahafi Nouranian, RN
• Brandon Nozawa, PHARM D
• Nu Dai Wellness
• Omar Manuel Nunez
• Vincent Nunez, LMFT

• Neurology Physician in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.