Provider Demographics
NPI:1427006824
Name:SHEYBANI, ALI (MD)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:
Last Name:SHEYBANI
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 1:4849 VAN NUYS BLVD
Mailing Address - Street 2:SITE 105
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2121
Mailing Address - Country:US
Mailing Address - Phone:818-905-9586
Mailing Address - Fax:818-905-0130
Practice Address - Street 1:4849 VAN NUYS BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-2121
Practice Address - Country:US
Practice Address - Phone:818-905-9586
Practice Address - Fax:818-905-0130
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA105260207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine