Healthcare Provider Details

I. General information

NPI: 1518889849
Provider Name (Legal Business Name): KAMYAR FARHANGFAR MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1234 GALSTON DR
FOLSOM CA
95630-6137
US

IV. Provider business mailing address

1015 RILEY ST # 6241
FOLSOM CA
95630-9973
US

V. Phone/Fax

Practice location:
  • Phone: 916-458-5435
  • Fax:
Mailing address:
  • Phone: 916-458-5435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083B0002X
TaxonomyObesity Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: KAMYAR FARHANGFAR
Title or Position: PRESIDENT
Credential: MD
Phone: 925-787-0094