| Provider / Organization | NPI | Date Certified |
|---|---|---|
| SHAHRAM FAZLALI | 1235745720 | 2020-09-20 |
Shahram Fazlali is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1235745720. Registration indicates Shahram Fazlali is a provider of services with a specialization in Nursing Service Related Providers, Home Health Aide (Home Health Aide, ) (Home Health Aide, Nursing Service Related Providers)
| Entity Type | Individual |
| Provider Name | Shahram Fazlali |
| Practice Office Address | 1575 COMFORT HILLS ST HENDERSON, NV US |
| Practice Office Telephone | 3104676710 |
| Mailing Address | 1575 COMFORT HILLS ST HENDERSON, NV 890147617 US |
| Business Telephone | 3104676710 |
| Code | Practice | License No State |
|---|---|---|
| 374U00000X PRIMARY | Nursing Service Related Providers Home Health Aide Home Health Aide Home Health Aide Nursing Service Related Providers | 002140367
CA |