MEDICARE: FARHAD ALIKOZAI DO

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	207R00000X	Internal Medicine Physician	DO2966	NV

General Provider Information

NPI Number	:	1760979678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FARHAD ALIKOZAI DO

Provider Business Mailing Address
First Line	:	8324 W CHARLESTON BLVD UNIT 2029
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-9206
Country	:	US
Telephone Number	:	661-803-1129
Fax Number	:

Provider Business Practice Location Address
First Line	:	10624 S EASTERN AVE
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-2982
Country	:	US
Telephone Number	:	661-803-1129
Fax Number	:

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

Provider Enumeration Date	:	04/16/2018
Last Update Date	:	08/18/2021

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