Provider Demographics
NPI:1174498935
Name:SHARAREH FIROUZBAKHT MD LLC
Entity type:Organization
Organization Name:SHARAREH FIROUZBAKHT MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OBGYN
Authorized Official - Prefix:
Authorized Official - First Name:SHARAREH
Authorized Official - Middle Name:
Authorized Official - Last Name:FIROUZBAKHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-428-8624
Mailing Address - Street 1:76-5914 MAMALAHOA HWY
Mailing Address - Street 2:
Mailing Address - City:HOLUALOA
Mailing Address - State:HI
Mailing Address - Zip Code:96725
Mailing Address - Country:US
Mailing Address - Phone:832-428-8624
Mailing Address - Fax:
Practice Address - Street 1:76-5914 MAMALAHOA HWY
Practice Address - Street 2:
Practice Address - City:HOLUALOA
Practice Address - State:HI
Practice Address - Zip Code:96725
Practice Address - Country:US
Practice Address - Phone:832-428-8624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-09
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center