Healthcare Provider Details

I. General information

NPI: 1770770257
Provider Name (Legal Business Name): RIAZ SHIRAZ DHANANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2007
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 YGNACIO VALLEY RD
WALNUT CREEK CA
94598-3122
US

IV. Provider business mailing address

175 LENNON LN SUITE 100
WALNUT CREEK CA
94598-2466
US

V. Phone/Fax

Practice location:
  • Phone: 925-296-7150
  • Fax: 925-296-7171
Mailing address:
  • Phone: 925-296-7150
  • Fax: 925-296-7171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA96921
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: