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NPI Code Detail

MEDICARE: MITRA SHEENA JAMSHIDIAN

MEDICARE:   MITRA SHEENA JAMSHIDIAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianA164761CA
2207RN0300XNephrology PhysicianA164761CA

General Provider Information

NPI Number : 1053800102
Entity Type Code : Individual
Provider Name (Legal Business Name) : MITRA SHEENA JAMSHIDIAN
Provider Business Mailing Address
First Line : PO BOX 743749
Second Line :
City : LOS ANGELES
State : CA
Zip : 90074-3749
Country : US
Telephone Number : 415-514-3000
Fax Number : 415-502-8175
Provider Business Practice Location Address
First Line : 1001 POTRERO AVE
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94110-3518
Country : US
Telephone Number : 619-543-6268
Fax Number : 619-543-6529
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2018
Last Update Date : 04/06/2026

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Directions to “ MITRA SHEENA JAMSHIDIAN ” Practice Location

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