Individual
SHAHRYAR MOUSAVI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
24953 PASEO DE VALENCIA, #3A, LAGUNA HILLS, CA 92653-4342
(949) 297-3838
Mailing address
35 CREEK RD, IRVINE, CA 92604-4724
(315) 464-4889
(949) 679-1084
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
A128033
CA
208VP0014X
Interventional Pain Medicine Physician
Primary
A128033
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB235450
MEDICARE PTAN
CA
Enumeration date
12/01/2008
Last updated
07/23/2015
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