MEDICARE: FARZIN KERENDIAN D.O.

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	2086S0122X	Plastic and Reconstructive Surgery Physician	20A7647	CA
2	208600000X	Surgery Physician	20A7647	CA

General Provider Information

NPI Number	:	1346388600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FARZIN KERENDIAN D.O.

Provider Business Mailing Address
First Line	:	PO BOX 10464
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90213-3464
Country	:	US
Telephone Number	:	310-274-4900
Fax Number	:	661-327-4404

Provider Business Practice Location Address
First Line	:	2080 CENTURY PARK E STE 607
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90067-2009
Country	:	US
Telephone Number	:	310-274-4900
Fax Number	:	310-613-6137

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

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	07/21/2022

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