Individual
DR. DANIEL SHAHROOZ BEHROOZAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M..D.
Contact information
Practice address
2221 LINCOLN BLVD, SUITE 100, SANTA MONICA, CA 90405-1320
(310) 392-1111
(310) 392-1101
Mailing address
2221 LINCOLN BLVD, SUITE 100, SANTA MONICA, CA 90405-1320
(310) 392-1111
(310) 392-1101
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A76756
CA
207ND0101X
MOHS-Micrographic Surgery Physician
A76756
CA
207NS0135X
Procedural Dermatology Physician
A76756
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A767560
MEDI-CAL PPIN
CA
01
—
WA76756D
MEDICARE PPIN
CA
Enumeration date
07/10/2006
Last updated
10/18/2007
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