MEDICARE: DR. NIMA L SHEMIRANI M.D.

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	207YS0123X	Facial Plastic Surgery Physician	A112498	CA

General Provider Information

NPI Number	:	1154402287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NIMA L SHEMIRANI M.D.

Provider Business Mailing Address
First Line	:	201 S LASKY DR
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-3610
Country	:	US
Telephone Number	:	310-772-2866
Fax Number	:	310-742-0367

Provider Business Practice Location Address
First Line	:	8641 WILSHIRE BLVD STE 305
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2921
Country	:	US
Telephone Number	:	310-772-2866
Fax Number	:	310-742-0367

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

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	11/04/2021

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