Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 35451 | CA |
Y | 213EG0000X | General Practice | 35451 | CA |
N | 1223P0106X | Oral and Maxillofacial Pathology | 35451 | CA |
NPI | 1184760852 |
---|---|
Provider Name | Dr. Danny Shiri |
First Address | Los Angeles, CA 90048-5454 |
Second Address | Los Angeles, CA 90048-5444 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 26/02/2020 |