Provider Demographics
NPI:1225091812
Name:KARIMIAN, SIAMAK (MD)
Entity Type:Individual
Prefix:DR
First Name:SIAMAK
Middle Name:
Last Name:KARIMIAN
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 1:4955 VAN NUYS BLVD
Mailing Address - Street 2:SUITE 415
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1801
Mailing Address - Country:US
Mailing Address - Phone:818-501-5686
Mailing Address - Fax:818-501-6151
Practice Address - Street 1:4955 VAN NUYS BLVD.
Practice Address - Street 2:SUITE 415
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1827
Practice Address - Country:US
Practice Address - Phone:818-501-5686
Practice Address - Fax:818-501-6151
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY48201207RC0000X
PAMD184976207RI0011X
CAA48218174400000X
ORMD184976207RI0011X
IDM-15992207RI0011X
MT43360207RI0011X
WI70710207RI0011X
TN55914207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A482180Medicaid
CA00A482182Medicare ID - Type Unspecified
CA00A482180Medicaid