Provider Demographics
NPI:1396137444
Name:SHIRAZI-NEJAD, SAMAN (DC)
Entity type:Individual
Prefix:DR
First Name:SAMAN
Middle Name:
Last Name:SHIRAZI-NEJAD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:SAM
Other - Middle Name:
Other - Last Name:SHIRAZI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:1106 N LA CIENEGA BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-2493
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1106 N LA CIENEGA BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90069-2493
Practice Address - Country:US
Practice Address - Phone:323-432-0014
Practice Address - Fax:323-212-6264
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33207111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor