Provider Demographics
NPI:1962069559
Name:SHIRAZI, ANAHEED (MD)
Entity type:Individual
Prefix:
First Name:ANAHEED
Middle Name:
Last Name:SHIRAZI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANAHEED
Other - Middle Name:
Other - Last Name:SHIRAZI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:200 W ARBOR DR # 8218
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-1911
Mailing Address - Country:US
Mailing Address - Phone:619-471-0283
Mailing Address - Fax:619-543-2092
Practice Address - Street 1:200 W ARBOR DR # 8218
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-1911
Practice Address - Country:US
Practice Address - Phone:619-471-0283
Practice Address - Fax:619-543-2092
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-20
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program