1114197589 NPI number — DR. SHEILA S NAZARIAN MOBIN M.D.

Table of content: DR. SHEILA S NAZARIAN MOBIN M.D. (NPI 1114197589)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114197589 NPI number — DR. SHEILA S NAZARIAN MOBIN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NAZARIAN MOBIN
Provider First Name:
SHEILA
Provider Middle Name:
S
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114197589
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/16/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
120 S. SPALDING DR #315
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEVERLY HILLS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90212
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-659-0500
Provider Business Mailing Address Fax Number:
310-388-1002

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10445 WILSHIRE BLVD
Provider Second Line Business Practice Location Address:
#1903
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90024-4634
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-621-1326
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/02/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208200000X , with the licence number:  A97647 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com