Organization
SHAHRAM JAVAHERI, MD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAHRAM JAVAHERI M.D. (CEO)
(949) 389-0660
Entity
Organization
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
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A642390
—
CA
Enumeration date
09/20/2006
Last updated
12/06/2018
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