MEDICARE: FARSHID MAHBOUBIRAD

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	246ZC0007X	Surgical Assistant	0136001095	VA

General Provider Information

NPI Number	:	1841146479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FARSHID MAHBOUBIRAD

Provider Business Mailing Address
First Line	:	12011 ROUTE 50 STE 501
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22033-3315
Country	:	US
Telephone Number	:	703-259-7027
Fax Number	:

Provider Business Practice Location Address
First Line	:	12011 ROUTE 50 STE 501
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22033-3315
Country	:	US
Telephone Number	:	703-259-7027
Fax Number	:

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

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/06/2026

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Directions to “ FARSHID MAHBOUBIRAD ” Practice Location

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