Organization
SHAHLA HESHMATI M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAHLA HESHMATI M.D. (PRESIDENT)
(949) 726-1100
Entity
Organization
Contact information
Practice address
15785 LAGUNA CANYON RD STE 250, IRVINE, CA 92618-3179
(949) 726-1100
Mailing address
PO BOX 4084, TUSTIN, CA 92781-4084
(949) 726-1100
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
A50416
CA
Other
Enumeration date
09/11/2010
Last updated
09/11/2010
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