Healthcare Provider Details

I. General information

NPI: 1902794597
Provider Name (Legal Business Name): SHIREEN GHORBANI, MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 LA CASA VIA STE 102
WALNUT CREEK CA
94598-3025
US

IV. Provider business mailing address

130 LA CASA VIA STE 102
WALNUT CREEK CA
94598-3025
US

V. Phone/Fax

Practice location:
  • Phone: 925-488-9006
  • Fax: 925-488-4277
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: SHIREEN GHORBANI
Title or Position: PRESIDENT/CEO
Credential: MD
Phone: 925-488-9006