Healthcare Provider Details

I. General information

NPI: 1467862920
Provider Name (Legal Business Name): VAHEH SHIRVANIAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: VAHEH SHIRVANIAN NAMAGERDI MD

II. Dates (important events)

Enumeration Date: 05/05/2014
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26910 SIERRA HWY STE D8
SANTA CLARITA CA
91321-2262
US

IV. Provider business mailing address

4343 WARM SPRINGS RD APT 2014
COLUMBUS GA
31909-5980
US

V. Phone/Fax

Practice location:
  • Phone: 661-388-5750
  • Fax:
Mailing address:
  • Phone: 818-641-9400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD.36367
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA151362
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: