Individual
DR. SHAHIN FAZILAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
515 SOUTH DR STE 25, MOUNTAIN VIEW, CA 94040-4209
(650) 964-2200
(650) 964-2205
Mailing address
515 SOUTH DR STE 25, MOUNTAIN VIEW, CA 94040-4209
(650) 964-2200
(650) 964-2205
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
A90907
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
92-0589712
TAX ID
CA
Enumeration date
11/01/2006
Last updated
06/16/2023
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