Provider Demographics
NPI:1437322971
Name:MEHDI, SHEHERBANO (MD)
Entity Type:Individual
Prefix:
First Name:SHEHERBANO
Middle Name:
Last Name:MEHDI
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 1:23441 MADISON ST
Mailing Address - Street 2:SUITE #340
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4725
Mailing Address - Country:US
Mailing Address - Phone:310-373-0340
Mailing Address - Fax:
Practice Address - Street 1:23441 MADISON ST
Practice Address - Street 2:SUITE #340
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4725
Practice Address - Country:US
Practice Address - Phone:310-373-0340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA88180207RR0500X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology