Healthcare Provider Details
I. General information
NPI: 1952486672
Provider Name (Legal Business Name): AFSHIN SHIRANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/25/2006
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6900 N PECOS RD
NORTH LAS VEGAS NV
89086-4400
US
IV. Provider business mailing address
6900 N PECOS RD
NORTH LAS VEGAS NV
89086-4400
US
V. Phone/Fax
- Phone: 702-791-9000
- Fax:
- Phone: 702-791-9000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 35051 |
| License Number State | IA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084S0012X |
| Taxonomy | Sleep Medicine (Psychiatry & Neurology) Physician |
| License Number | 35051 |
| License Number State | IA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084S0012X |
| Taxonomy | Sleep Medicine (Psychiatry & Neurology) Physician |
| License Number | 15006 |
| License Number State | NH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: