Provider Demographics
NPI:1548219140
Name:AFRASIABI, SHIRIN (MD INC)
Entity Type:Individual
Prefix:DR
First Name:SHIRIN
Middle Name:
Last Name:AFRASIABI
Suffix:
Gender:F
Credentials:MD INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 NEWPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-1516
Mailing Address - Country:US
Mailing Address - Phone:949-548-5700
Mailing Address - Fax:949-548-5703
Practice Address - Street 1:2301 NEWPORT BLVD
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-1516
Practice Address - Country:US
Practice Address - Phone:949-548-5700
Practice Address - Fax:949-548-5703
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54306207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine