Healthcare Provider Details

I. General information

NPI: 1427995950
Provider Name (Legal Business Name): SHIRIN VARTAK PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 S SIERRA AVE UNIT 162
SOLANA BEACH CA
92075-8008
US

IV. Provider business mailing address

PO BOX 162
SOLANA BEACH CA
92075-0162
US

V. Phone/Fax

Practice location:
  • Phone: 858-304-0053
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SHIRIN VARTAK
Title or Position: OWNER
Credential: DO
Phone: 858-304-0053