Healthcare Provider Details

I. General information

NPI: 1487679890
Provider Name (Legal Business Name): PARISA JAMSHIDI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PARISA JAMSHIDI MD

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 10/31/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13744 E CALEY DR
CENTENNIAL CO
80111-2433
US

IV. Provider business mailing address

P.O. BOX 173862
DENVER CO
80217-3862
US

V. Phone/Fax

Practice location:
  • Phone: 314-570-3210
  • Fax:
Mailing address:
  • Phone: 303-306-7783
  • Fax: 303-306-7753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number115974
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number036-101222
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberV4037
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number341732
License Number StateLA
# 5
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License NumberDR.0052912
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: