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General NPI Number Information
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NPI Number | 1134395320
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Entity Type | Individual
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Provider Name | JAMSHID JAMES SHARIATI MD
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Gender | Male
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Dates
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Enumeration Date | 05/07/2008
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Last Update Date | 04/13/2016
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Provider Practice Location Address
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Address Line | 1117 W MANCHESTER BLVD SUITE K
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City | INGLEWOOD
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State | CA
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Zip | 90301-1500
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Country | US
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Telephone | 310-215-3555
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Fax | 310-215-3587
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Provider Business Mailing Address
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Address Line | 4267 MARINA CITY DR UNIT 114
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City | MARINA DEL REY
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State | CA
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Zip | 90292-5810
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Country | US
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Telephone | 310-846-9777
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Fax | 310-846-9776
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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 | A105315
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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