Provider Demographics
NPI:1184714610
Name:HOODEI, SHIRIN (MD)
Entity type:Individual
Prefix:
First Name:SHIRIN
Middle Name:
Last Name:HOODEI
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 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:650-853-2904
Mailing Address - Fax:
Practice Address - Street 1:795 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2302
Practice Address - Country:US
Practice Address - Phone:650-853-2904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA972822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGE488NMedicare PIN
CAGE488QMedicare PIN
CAGE488RMedicare PIN
CAGE488OMedicare PIN
CADJ688AMedicare PIN
CAGE488LMedicare PIN
CAGE488MMedicare PIN
CAGE488KMedicare PIN
CAGE488UMedicare PIN
CAGE488PMedicare PIN
CAGE488TMedicare PIN