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General NPI Number Information
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NPI Number | 1942415823
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Entity Type | Individual
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Provider Name | AMIR HOSSEIN DORAFSHAR MD
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Gender | Male
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Dates
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Enumeration Date | 05/13/2007
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 60 E DELAWARE PL STE 1430
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City | CHICAGO
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State | IL
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Zip | 60611-1495
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Country | US
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Telephone | 312-278-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 23055 SHERMAN WAY UNIT 4245
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City | WEST HILLS
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State | CA
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Zip | 91308-7015
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Country | US
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Telephone | 312-371-4248
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | D36424
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 036.114329
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License Number State | IL
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