Healthcare Provider Details

I. General information

NPI: 1487743597
Provider Name (Legal Business Name): SEAN SHAHRIAR SHAHANGIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: SHAHRIAR SHAHANGIAN MD

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 02/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 N HOOVER ST
LOS ANGELES CA
90004-3627
US

IV. Provider business mailing address

5221 CROWN AVENUE
LA CANADA FLINTRIDGE CA
91011-2805
US

V. Phone/Fax

Practice location:
  • Phone: 213-382-4823
  • Fax:
Mailing address:
  • Phone:
  • Fax: 818-952-5147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA67216
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: