Provider Demographics
NPI:1619001203
Name:KASHANI, SHIRIN (DAOM, LAC)
Entity Type:Individual
Prefix:DR
First Name:SHIRIN
Middle Name:
Last Name:KASHANI
Suffix:
Gender:F
Credentials:DAOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11704 WILSHIRE BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-1504
Mailing Address - Country:US
Mailing Address - Phone:310-740-2889
Mailing Address - Fax:
Practice Address - Street 1:11704 WILSHIRE BLVD STE 206
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1504
Practice Address - Country:US
Practice Address - Phone:310-740-2889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10893171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist