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Organization

KEYVAN SHIRAZI, MD

Active
Parent organization
KEYVAN SHIRAZI, MD
Organization subpart
Yes

Provider details

NPI number
Legal business name
KEYVAN SHIRAZI, MD
Authorized official
KEYVAN SHIRAZI M.D. (MEDICAL DIRECTOR)
(818) 789-3964
Entity
Organization

Contact information

Practice address
16952 VENTURA BLVD, SUITE 100, ENCINO, CA 91316-4197
(818) 789-3964
Mailing address
16952 VENTURA BLVD, SUITE 100, ENCINO, CA 91316-4197
(818) 789-3964

Taxonomy

Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary

Other

Enumeration date
10/05/2010
Last updated
03/01/2011
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