Provider Demographics
NPI:1154402287
Name:SHEMIRANI, NIMA L (MD)
Entity type:Individual
Prefix:DR
First Name:NIMA
Middle Name:L
Last Name:SHEMIRANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 S LASKY DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-3610
Mailing Address - Country:US
Mailing Address - Phone:310-772-2866
Mailing Address - Fax:310-742-0367
Practice Address - Street 1:8641 WILSHIRE BLVD STE 305
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2921
Practice Address - Country:US
Practice Address - Phone:310-772-2866
Practice Address - Fax:310-742-0367
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA112498207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEY591AMedicare PIN
AZZ143125Medicare PIN