MEDICARE: DR. SHIR ALI MISKINYAR 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	2086S0122X	Plastic and Reconstructive Surgery Physician	A50080	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A50080	OTHER	CA	CLAIFORNIA STATE LICENSE

General Provider Information

NPI Number	:	1477766582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHIR ALI MISKINYAR M.D.

Provider Business Mailing Address
First Line	:	817 W 17TH ST
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92706-3624
Country	:	US
Telephone Number	:	714-481-1685
Fax Number	:	714-481-1687

Provider Business Practice Location Address
First Line	:	817 W 17TH ST
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92706-3624
Country	:	US
Telephone Number	:	714-481-1685
Fax Number	:	714-481-1687

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

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	02/01/2026

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