Individual
DR. MARIAM SHANAZ AMIRI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
11332 MOUNTAIN VIEW AVE, SUITE A, LOMA LINDA, CA 92354-3854
(909) 796-3707
(909) 796-3709
Mailing address
PO BOX 1059, LOMA LINDA, CA 92354-1059
(909) 796-3707
(909) 796-3709
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E4049
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E40490
—
CA
Enumeration date
08/31/2006
Last updated
08/24/2021
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