Healthcare Provider Details

I. General information

NPI: 1659631851
Provider Name (Legal Business Name): ARTA FARSHIDI, MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2012
Last Update Date: 02/18/2020
Certification Date: 02/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 HOSPITAL RD SUITE 209
NEWPORT BEACH CA
92663-3509
US

IV. Provider business mailing address

351 HOSPITAL RD STE 209
NEWPORT BEACH CA
92663-3504
US

V. Phone/Fax

Practice location:
  • Phone: 949-646-3333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: ARTA FARSHIDI
Title or Position: CEO
Credential:
Phone: 949-646-3333