Provider Demographics
NPI:1205188471
Name:GUITY SHAFE, PIRASTEH (MD)
Entity Type:Individual
Prefix:
First Name:PIRASTEH
Middle Name:
Last Name:GUITY SHAFE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PIRA
Other - Middle Name:S
Other - Last Name:GUITY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:P.O BOX 4948
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762
Mailing Address - Country:US
Mailing Address - Phone:916-719-9227
Mailing Address - Fax:
Practice Address - Street 1:5001 GRESHAM DR
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762
Practice Address - Country:US
Practice Address - Phone:916-939-4248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAFE41451208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics