MEDICARE: DR. SHAHNAZ MIRI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	A181700	CA
2	207WX0109X	Neuro-ophthalmology Physician	A181700	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043605397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAHNAZ MIRI M.D.

Provider Business Mailing Address
First Line	:	582 MARKET ST STE 717
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94104-5308
Country	:	US
Telephone Number	:	415-800-4178
Fax Number	:	415-800-4942

Provider Business Practice Location Address
First Line	:	582 MARKET ST STE 717
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94104-5308
Country	:	US
Telephone Number	:	415-800-4178
Fax Number	:	415-800-4942

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2015
Last Update Date	:	05/14/2026

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