MEDICARE: FARNOOSH ABBASI D.D.S, M.D.S

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	1223E0200X	Endodontics	61211	CA

General Provider Information

NPI Number	:	1437423407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FARNOOSH ABBASI D.D.S, M.D.S

Provider Business Mailing Address
First Line	:	2013 CANVAS WAY
Second Line	:
City	:	MARINA
State	:	CA
Zip	:	93933-6022
Country	:	US
Telephone Number	:	831-741-6631
Fax Number	:

Provider Business Practice Location Address
First Line	:	2013 CANVAS WAY
Second Line	:
City	:	MARINA
State	:	CA
Zip	:	93933-6022
Country	:	US
Telephone Number	:	831-741-6631
Fax Number	:

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

Provider Enumeration Date	:	03/08/2012
Last Update Date	:	06/02/2026

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