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General NPI Number Information
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NPI Number | 1073399804
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Entity Type | Organization
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Legal Business Name | DOA PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 09/07/2023
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 24335 MAGIC MOUNTAIN PKWY
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City | SANTA CLARITA
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State | CA
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Zip | 91355-3402
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Country | US
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Telephone | 818-624-1290
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Fax |
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Provider Business Mailing Address
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Address Line | 3893 VILLA VISTA PL
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City | CONCORD
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State | CA
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Zip | 94521-2028
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Country | US
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Telephone | 818-624-1290
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Fax |
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Authorized Official
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Title or Position | MD
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Name | VAHEH SHIRVANIAN
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Credential | MD
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Telephone | 818-624-1290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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