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General NPI Number Information
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NPI Number | 1467239251
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Entity Type | Individual
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Provider Name | SHAYAN VEISSI FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 09/13/2023
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Last Update Date | 09/13/2023
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Provider Practice Location Address
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Address Line | 7923 GARDEN GROVE BLVD
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City | GARDEN GROVE
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State | CA
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Zip | 92841-4225
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Country | US
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Telephone | 714-799-5858
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Fax |
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Provider Business Mailing Address
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Address Line | 67 PINEWOOD
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City | IRVINE
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State | CA
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Zip | 92604-3239
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Country | US
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Telephone | 949-838-6961
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95026288
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License Number State | CA
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