Provider Demographics
NPI:1205068384
Name:SHARIFIAN, NASTARAN (MD)
Entity type:Individual
Prefix:
First Name:NASTARAN
Middle Name:
Last Name:SHARIFIAN
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 1:2228 CROSS ST
Mailing Address - Street 2:
Mailing Address - City:LA CANADA
Mailing Address - State:CA
Mailing Address - Zip Code:91011-1406
Mailing Address - Country:US
Mailing Address - Phone:818-667-5551
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF KENTUCKY & AFFILIATES
Practice Address - Street 2:800 ROSE STREET
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:859-257-1363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-21
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program