Provider Demographics
NPI:1205903242
Name:SHIRAZI, ABUL H (MD)
Entity type:Individual
Prefix:
First Name:ABUL
Middle Name:H
Last Name:SHIRAZI
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 1:9849 MELVIN AVENUE
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-1636
Mailing Address - Country:US
Mailing Address - Phone:818-372-0656
Mailing Address - Fax:818-709-6358
Practice Address - Street 1:9849 MELVIN AVE
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-1636
Practice Address - Country:US
Practice Address - Phone:818-372-0656
Practice Address - Fax:818-709-6358
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA440722084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA44072DMedicare PIN