Provider Demographics
NPI:1538191507
Name:ESHRAGHI, SHERVIN (MD)
Entity type:Individual
Prefix:DR
First Name:SHERVIN
Middle Name:
Last Name:ESHRAGHI
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:PO BOX 9602
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91346-9602
Mailing Address - Country:US
Mailing Address - Phone:213-394-7921
Mailing Address - Fax:336-718-7598
Practice Address - Street 1:23803 MCBEAN PWKY SUITE 202
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-2001
Practice Address - Country:US
Practice Address - Phone:661-481-2400
Practice Address - Fax:661-255-5626
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005-018042084N0600X, 2084N0400X, 208M00000X
CAA1729412084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC141PTOtherNCBCBS
NC5902669Medicaid
SCN01804Medicaid
FL122298500Medicaid
NCI47594Medicare UPIN
NC5902669Medicaid
SCN01804Medicaid