Shahin Mirkof, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

28634 Issued in CA

Practice address

550 S Vermont Ave
9TH FLR, Eob
Los Angeles, CA 90020-1912

Phone

(213) 949-6055

NPI assigned

Sep 4, 2013

Last updated

Oct 31, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1598190977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S VERMONT AVE",
            "address_2": "9TH FLR, EOB",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S VERMONT AVE",
            "address_2": "9TH FLR, EOB",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900201912",
            "telephone_number": "213-949-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRKOF",
        "first_name": "SHAHIN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-04",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "28634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miriam Romero DMD Inc (Vermont Dental Care)
• Alexander Miric, MD
• Neeki Mirkhani, PHARMD
• Abigail Elana Mirkin, MPAP, PA-C
• Nicole Amanda Mirkin, M.ED.
• Drew Lauren Mirman
• Joshua Lawrence Mirmelli, PSYD
• Julissa Miro Quesada
• Usha S Mirpuri, LCSW
• Evan Mirsberger

• Clinical Psychologist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.