Healthcare Provider Details

I. General information

NPI: 1932376514
Provider Name (Legal Business Name): FARHAD ARDESHIRPOUR-ZARTOSHTI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: FARHAD ARDESHIRPOUR MD

II. Dates (important events)

Enumeration Date: 05/13/2008
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 S RODEO DR #260
BEVERLY HILLS CA
90212-2445
US

IV. Provider business mailing address

PO BOX 16542
IRVINE CA
92623-6542
US

V. Phone/Fax

Practice location:
  • Phone: 424-242-8608
  • Fax: 424-242-0410
Mailing address:
  • Phone: 424-242-8608
  • Fax: 424-242-0410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2082S0099X
TaxonomyPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician
License NumberA132714
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberA132714
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2082S0099X
TaxonomyPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician
License Number307473-01
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License NumberA132714
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberMD60365940
License Number StateWA
# 6
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberA132714
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License NumberA132714
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License NumberMD224023
License Number StateOR
# 9
Primary TaxonomyN
Taxonomy Code2082S0099X
TaxonomyPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician
License NumberME171331
License Number StateFL
# 10
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberA132714
License Number StateCA
# 11
Primary TaxonomyN
Taxonomy Code2082S0099X
TaxonomyPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician
License NumberMD60365940
License Number StateWA
# 12
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License NumberMD60365940
License Number StateWA
# 13
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberMD224023
License Number StateOR
# 14
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA132714
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: