Healthcare Provider Details

I. General information

NPI: 1114187556
Provider Name (Legal Business Name): AZIN SHAHRYARINEJAD M.D., M.P.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2008
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 ROSECRANS AVE # 4B
MANHATTAN BEACH CA
90266-3708
US

IV. Provider business mailing address

742 27TH ST
MANHATTAN BEACH CA
90266-2363
US

V. Phone/Fax

Practice location:
  • Phone: 310-893-7046
  • Fax:
Mailing address:
  • Phone: 917-847-6561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberA93629
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: