=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538491980
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SHAHRIAR ALIKHANI MD INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/10/2010
-----------------------------------------------------
Last Update Date | 03/24/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 23025 MILL CREEK DRIVE
-----------------------------------------------------
City | LAGUNA HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92653
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-367-0800
-----------------------------------------------------
Fax | 949-313-7858
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 23025 MILL CREEK DRIVE
-----------------------------------------------------
City | LAGUNA HILLS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92653
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-367-0800
-----------------------------------------------------
Fax | 949-313-7858
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | DR. SHAHRIAR ALIKHANI
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 949-367-0800
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | G75045
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------