Healthcare Provider Details

I. General information

NPI: 1780524579
Provider Name (Legal Business Name): AFSHIN SHABANIE MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 VIEW TER
IRVINE CA
92603-0213
US

IV. Provider business mailing address

45 VIEW TER
IRVINE CA
92603-0213
US

V. Phone/Fax

Practice location:
  • Phone: 310-780-3316
  • Fax:
Mailing address:
  • Phone: 310-780-3316
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: AFSHIN SHABANIE
Title or Position: MD
Credential: MD
Phone: 310-780-3316