Healthcare Provider Details

I. General information

NPI: 1578973467
Provider Name (Legal Business Name): EMAAD FAROOQUI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2014
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 UPPER RAGSDALE DR STE B230
MONTEREY CA
93940-7853
US

IV. Provider business mailing address

100 WILSON RD STE 100
MONTEREY CA
93940-7885
US

V. Phone/Fax

Practice location:
  • Phone: 831-649-0808
  • Fax: 831-649-8795
Mailing address:
  • Phone: 831-649-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberA140180
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: