Healthcare Provider Details

I. General information

NPI: 1144545534
Provider Name (Legal Business Name): FARAHNAZ ESKANDARI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2010
Last Update Date: 06/03/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9229 WILSHIRE BLVD
BEVERLY HILLS CA
90210-5501
US

IV. Provider business mailing address

145 S CANON DR UNIT 202
BEVERLY HILLS CA
90212-3110
US

V. Phone/Fax

Practice location:
  • Phone: 281-536-6897
  • Fax:
Mailing address:
  • Phone: 281-536-6897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number169450
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number169450
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number169450
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: