Provider Demographics
NPI:1164458816
Name:SHIRZAD, PEDRAM (DO)
Entity Type:Individual
Prefix:DR
First Name:PEDRAM
Middle Name:
Last Name:SHIRZAD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 27206
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027
Mailing Address - Country:US
Mailing Address - Phone:818-941-1716
Mailing Address - Fax:888-906-3136
Practice Address - Street 1:7230 MEDICAL CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307
Practice Address - Country:US
Practice Address - Phone:818-941-1716
Practice Address - Fax:888-906-3136
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-24
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9014207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine