MEDICARE: DR. FARIBA DANESHGARAN OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	11815	CA
2	152W00000X	Optometrist	3523	WA

General Provider Information

NPI Number	:	1043339252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FARIBA DANESHGARAN OD

Provider Business Mailing Address
First Line	:	9 LAKE BELLEVUE DR STE 208
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98005-2454
Country	:	US
Telephone Number	:	425-777-1089
Fax Number	:

Provider Business Practice Location Address
First Line	:	9 LAKE BELLEVUE DR STE 208
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98005-2454
Country	:	US
Telephone Number	:	425-777-1089
Fax Number	:	425-285-8029

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	10/16/2024

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