Provider Demographics
NPI:1154788289
Name:MULTI-SPECIALTY HEALTHCARE MANAGEMENT SERVICES, INC.
Entity type:Organization
Organization Name:MULTI-SPECIALTY HEALTHCARE MANAGEMENT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PEJMAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:SHIRAZY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-789-3964
Mailing Address - Street 1:16952 VENTURA BLVD STE 100-A
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-4197
Mailing Address - Country:US
Mailing Address - Phone:818-789-3964
Mailing Address - Fax:818-789-3967
Practice Address - Street 1:16952 VENTURA BLVD STE 100-A
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-4197
Practice Address - Country:US
Practice Address - Phone:818-789-3964
Practice Address - Fax:818-789-3967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-20
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA583427261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA583427OtherJACHO ORGANIZATION IDENTIFICATION NUMBER