Provider Demographics
NPI:1114187556
Name:SHAHRYARINEJAD, AZIN (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:AZIN
Middle Name:
Last Name:SHAHRYARINEJAD
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:742 27TH ST
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-2363
Mailing Address - Country:US
Mailing Address - Phone:310-893-7046
Mailing Address - Fax:
Practice Address - Street 1:4201 TORRANCE BLVD STE 745
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4520
Practice Address - Country:US
Practice Address - Phone:310-893-7046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA93629207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery