Provider Demographics
NPI:1861446833
Name:ALIKHANI, SHAHRIAR (MD)
Entity Type:Individual
Prefix:
First Name:SHAHRIAR
Middle Name:
Last Name:ALIKHANI
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 1:23025 MILL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1257
Mailing Address - Country:US
Mailing Address - Phone:949-367-0800
Mailing Address - Fax:949-313-7858
Practice Address - Street 1:23025 MILL CREEK DR
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1257
Practice Address - Country:US
Practice Address - Phone:949-367-0800
Practice Address - Fax:949-313-7858
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG75045207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G750450Medicaid
WG75045AMedicare PIN
CAG20556Medicare UPIN