Healthcare Provider Details

I. General information

NPI: 1760770374
Provider Name (Legal Business Name): NEDA SHIRZADI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2011
Last Update Date: 08/11/2021
Certification Date: 08/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 SAMARITAN DR
SAN JOSE CA
95124
US

IV. Provider business mailing address

4300 UNION SPRINGS LN
ARRINGTON TN
37014-1409
US

V. Phone/Fax

Practice location:
  • Phone: 408-559-2011
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberA123593
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: