Healthcare Provider Details

I. General information

NPI: 1659290781
Provider Name (Legal Business Name): FARSYAR FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2366 CABALLO RANCHERO DRIVE
DIABLO CA
94528
US

IV. Provider business mailing address

2366 CABALLO RANCHERO DR
DIABLO CA
94528
US

V. Phone/Fax

Practice location:
  • Phone: 925-577-0933
  • Fax:
Mailing address:
  • Phone: 925-577-0933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MAHDOKHT DORIE OFOGH
Title or Position: ADMINISTRATOR
Credential: PHARM. D.
Phone: 925-577-0933