Shahla Chehrazi, M.D.

Individual provider Active NPI Specialist · Kentfield, CA

NPI 1487761995 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1487761995
Entity type
Individual (NPI type 1)
Primary specialty
Specialist 174400000X
License
A30503 (CA)
Practice address
35 Wolfe Grade
Kentfield, CA 94904-1011
Phone
(415) 925-1445
Fax
(415) 461-6112
NPI assigned
Aug 23, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A30503CAMDSpecialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A30503 CA Yes

Addresses

Primary practice location

35 Wolfe Grade
Kentfield, CA 94904-1011

Mailing address

35 Wolfe Grade
Kentfield, CA 94904-1011
Phone (415) 925-1445

Other providers in Kentfield, CA

All providers in Kentfield, CA · Specialist in California

Sources for this page

Verify at the official NPI Registry.