Provider Demographics
NPI:1164685111
Name:CHORBAJIAN, SHAGHIG ROMOFIT (MD)
Entity Type:Individual
Prefix:
First Name:SHAGHIG
Middle Name:ROMOFIT
Last Name:CHORBAJIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5210 PREMIERE HILLS CIR APT 237
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-0872
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4940 VAN NUYS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1741
Practice Address - Country:US
Practice Address - Phone:626-394-8249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN12609207Q00000X
FLME108674207Q00000X, 208M00000X
CAA133382207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA133382OtherCALIFORNIA MEDICAL BOARD
CAA133382OtherCALIFORNIA MEDICAL BOARD