Individual
DR. SHAHRAM JAVAHERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
26691 PLAZA STE 150, MISSION VIEJO, CA 92691-6329
(949) 389-0660
(949) 389-0668
Mailing address
PO BOX 12512, NEWPORT BEACH, CA 92658-5065
(949) 389-0660
(949) 389-0668
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A064239
CA
207RG0100X
Gastroenterology Physician
MED-PHYS-LIC-114422
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A642390
—
CA
Enumeration date
08/22/2006
Last updated
08/04/2022
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