Provider Demographics
NPI:1801988282
Name:SHIRVANI, VIVIAN NEGAR (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:NEGAR
Last Name:SHIRVANI
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16411
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90209-2411
Mailing Address - Country:US
Mailing Address - Phone:310-592-2377
Mailing Address - Fax:310-423-4599
Practice Address - Street 1:8700 BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-1804
Practice Address - Country:US
Practice Address - Phone:310-657-9277
Practice Address - Fax:310-423-4599
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72441207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A724410OtherBLUE SHIELD
CA00A724410OtherBLUE SHIELD