Healthcare Provider Details

I. General information

NPI: 1376713875
Provider Name (Legal Business Name): SHAHRIAR SEAN PARSA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: SHAHRIAR SEAN PARSA M.D.

II. Dates (important events)

Enumeration Date: 03/11/2008
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 N BASCOM AVE STE 104
SAN JOSE CA
95128-1811
US

IV. Provider business mailing address

105 N BASCOM AVE STE 104
SAN JOSE CA
95128-1811
US

V. Phone/Fax

Practice location:
  • Phone: 408-918-0405
  • Fax: 408-918-0409
Mailing address:
  • Phone: 408-918-0405
  • Fax: 408-918-0409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA101165
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: