Provider Demographics
NPI:1730571233
Name:SIMIAN, SHAHEN
Entity type:Individual
Prefix:
First Name:SHAHEN
Middle Name:
Last Name:SIMIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 N HOLLYWOOD WAY UNIT 200
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-2149
Mailing Address - Country:US
Mailing Address - Phone:818-688-2275
Mailing Address - Fax:
Practice Address - Street 1:1209 N HOLLYWOOD WAY UNIT 200
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-2149
Practice Address - Country:US
Practice Address - Phone:818-688-2275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-20
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33195111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor