MEDICARE: SHARWIN TAFAZOLI INC

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	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1447806278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHARWIN TAFAZOLI INC

Provider Business Mailing Address
First Line	:	1819 WASHINGTON AVE APT A
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-3324
Country	:	US
Telephone Number	:	310-382-0233
Fax Number	:

Provider Business Practice Location Address
First Line	:	8224 LATONA AVE NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115-4055
Country	:	US
Telephone Number	:	310-382-0233
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHARWIN TAFAZOLI
Credential	:	MD
Telephone Number	:	310-382-0233

Provider Enumeration Date	:	08/16/2019
Last Update Date	:	01/02/2026

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