Individual
AZADEH R SHIRAZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7301 GIRARD AVE STE 202, LA JOLLA, CA 92037-5151
(858) 456-3992
(858) 456-5060
Mailing address
7301 GIRARD AVE STE 202, LA JOLLA, CA 92037-5151
(858) 456-3992
(858) 456-5060
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
34468
AZ
207N00000X
Dermatology Physician
Primary
BA9592014
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86080015085259C453
TRIWEST
AZ
05
—
957574
—
AZ
01
—
P00251141
RAILROAD MEDICARE
AZ
Enumeration date
11/30/2005
Last updated
05/18/2022
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