Provider Demographics
NPI:1386084457
Name:MEHRIZI, SAMIRA (DPM)
Entity type:Individual
Prefix:DR
First Name:SAMIRA
Middle Name:
Last Name:MEHRIZI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4007 HUNT CLUB CT.
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301
Mailing Address - Country:US
Mailing Address - Phone:310-877-9114
Mailing Address - Fax:
Practice Address - Street 1:1687 ERRINGER RD STE 206
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-6509
Practice Address - Country:US
Practice Address - Phone:805-742-4442
Practice Address - Fax:562-630-0052
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE-5081213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery