Healthcare Provider Details

I. General information

NPI: 1134395320
Provider Name (Legal Business Name): JAMSHID JAMES SHARIATI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2008
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 W MANCHESTER BLVD
INGLEWOOD CA
90301-1110
US

IV. Provider business mailing address

4267 MARINA CITY DR UNIT 114
MARINA DEL REY CA
90292-5810
US

V. Phone/Fax

Practice location:
  • Phone: 310-215-3555
  • Fax: 310-988-2669
Mailing address:
  • Phone: 310-846-9777
  • Fax: 310-846-9776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA105315
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: