Provider Demographics
NPI:1285800359
Name:KAMRAVA, DAVID SHAHRIAR (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:SHAHRIAR
Last Name:KAMRAVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SHAHRIAR
Other - Middle Name:DAVID
Other - Last Name:KAMRAVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 77790
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92877-0126
Mailing Address - Country:US
Mailing Address - Phone:800-626-2468
Mailing Address - Fax:951-272-9924
Practice Address - Street 1:7320 WOODLAKE AVE
Practice Address - Street 2:290
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1468
Practice Address - Country:US
Practice Address - Phone:818-716-6446
Practice Address - Fax:818-716-9869
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102042207RC0200X, 208M00000X, 207RP1001X
AZ40801208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist