MEDICARE: DR. ARSHIYA SHARAFI DDS

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
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	57540	CA

General Provider Information

NPI Number	:	1104962190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARSHIYA SHARAFI DDS

Provider Business Mailing Address
First Line	:	4125 SORRENTO VALLEY BLVD
Second Line	:	D
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-1423
Country	:	US
Telephone Number	:	858-997-2701
Fax Number	:	858-550-5954

Provider Business Practice Location Address
First Line	:	4910 DIRECTORS PL
Second Line	:	301
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-3811
Country	:	US
Telephone Number	:	858-997-2701
Fax Number	:	858-768-0510

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	04/20/2015

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