MEDICARE: SYED SHIRAZ MAZHAR MBBS

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1215874060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYED SHIRAZ MAZHAR MBBS

Provider Business Mailing Address
First Line	:	CHINO VALLEY MEDICAL CENTER PROGRAM, FAMILY MEDICINE
Second Line	:	5451 WALNUT AVE
City	:	CHINO, CHINO
State	:	CA
Zip	:	91710
Country	:	US
Telephone Number	:	909-464-8600
Fax Number	:

Provider Business Practice Location Address
First Line	:	CHINO VALLEY MEDICAL CENTER PROGRAM, FAMILY MEDICINE
Second Line	:	5451 WALNUT AVE
City	:	CHINO, CHINO
State	:	CA
Zip	:	91710
Country	:	US
Telephone Number	:	909-464-8600
Fax Number	:

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

Provider Enumeration Date	:	04/30/2026
Last Update Date	:	04/30/2026

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