Individual
SANAM TIFFANY SHAHROOZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2080 CENTURY PARK E STE 911, LOS ANGELES, CA 90067-2012
(310) 229-1220
(310) 229-1222
Mailing address
2080 CENTURY PARK E STE 911, LOS ANGELES, CA 90067-2012
(310) 229-1220
(310) 229-1222
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A185754
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390200000X
—
CA
Enumeration date
06/16/2019
Last updated
07/10/2023
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