Provider Demographics
NPI:1417583550
Name:SHIRAZI, ELIZABETH MEENA
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MEENA
Last Name:SHIRAZI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2277 FAIR OAKS BLVD STE 355
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-5595
Mailing Address - Country:US
Mailing Address - Phone:916-273-1789
Mailing Address - Fax:
Practice Address - Street 1:2277 FAIR OAKS BLVD STE 355
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-5595
Practice Address - Country:US
Practice Address - Phone:916-927-3178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-20
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA178639207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology