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: 07/15/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 REDWOOD HWY FRONTAGE RD STE 367
MILL VALLEY CA
94941-3013
US

IV. Provider business mailing address

219 REED BLVD
MILL VALLEY CA
94941-2503
US

V. Phone/Fax

Practice location:
  • Phone: 214-494-9125
  • Fax:
Mailing address:
  • Phone: 650-380-6866
  • 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: 650-380-6866