Individual
DR. FARDIS SHAHRIVAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 JOSE FIGUERES AVE, SUITE 295, SAN JOSE, CA 95116-1500
(408) 729-4473
Mailing address
200 JOSE FIGUERES AVE, SUITE 295, SAN JOSE, CA 95116-1500
(408) 729-4473
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
AO49985
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A499851
—
CA
Enumeration date
09/14/2006
Last updated
05/22/2008
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