Provider Demographics
NPI:1588825129
Name:ALBORZIAN, SHERVIN (MD)
Entity Type:Individual
Prefix:
First Name:SHERVIN
Middle Name:
Last Name:ALBORZIAN
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 1:9834 GENESEE AVE STE 209
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1225
Mailing Address - Country:US
Mailing Address - Phone:858-457-2220
Mailing Address - Fax:858-457-2318
Practice Address - Street 1:9834 GENESEE AVE STE 209
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037
Practice Address - Country:US
Practice Address - Phone:858-457-2220
Practice Address - Fax:858-457-2318
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA107093207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty