Provider Demographics
NPI:1033145701
Name:SHARIM, HOMAYOUN (MD)
Entity Type:Individual
Prefix:
First Name:HOMAYOUN
Middle Name:
Last Name:SHARIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 GLENMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-3204
Mailing Address - Country:US
Mailing Address - Phone:818-547-6000
Mailing Address - Fax:818-547-6024
Practice Address - Street 1:9301 WILSHIRE BLVD
Practice Address - Street 2:SUITE 512
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5424
Practice Address - Country:US
Practice Address - Phone:310-657-8000
Practice Address - Fax:310-276-4795
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45456207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW18448Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER