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General NPI Number Information
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NPI Number | 1043419484
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Entity Type | Individual
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Provider Name | SHAHRAM SALIMITARI M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 12/15/2022
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Provider Practice Location Address
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Address Line | 17609 VENTURA BLVD STE 106
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City | ENCINO
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State | CA
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Zip | 91316-3866
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Country | US
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Telephone | 818-774-2755
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Fax |
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Provider Business Mailing Address
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Address Line | 449 N BUNDY DR
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City | LOS ANGELES
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State | CA
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Zip | 90049-2829
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Country | US
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Telephone | 773-469-4611
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | TRN11167
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License Number State | FL
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