Healthcare Provider Details

I. General information

NPI: 1194645770
Provider Name (Legal Business Name): SHERWIN ABDOLI MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 MOWRY AVE
FREMONT CA
94538-1746
US

IV. Provider business mailing address

PO BOX 60049
ARCADIA CA
91066-6049
US

V. Phone/Fax

Practice location:
  • Phone: 510-797-1111
  • Fax:
Mailing address:
  • Phone: 214-494-9125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: SHERWIN ABDOLI
Title or Position: OWNER, DIRECTOR
Credential: MD
Phone: 214-494-9125