Provider Demographics
NPI:1417008772
Name:JARCHI, SHAHRIAR (MD)
Entity type:Individual
Prefix:DR
First Name:SHAHRIAR
Middle Name:
Last Name:JARCHI
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 1:1171 S ROBERTSON BLVD
Mailing Address - Street 2:SUITE #242
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-1403
Mailing Address - Country:US
Mailing Address - Phone:626-765-4321
Mailing Address - Fax:310-657-8728
Practice Address - Street 1:1171 S ROBERTSON BLVD
Practice Address - Street 2:SUITE #242
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-1403
Practice Address - Country:US
Practice Address - Phone:626-765-4321
Practice Address - Fax:866-931-3134
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA96880207RH0002X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABO738ZMedicare PIN