Healthcare Provider Details

I. General information

NPI: 1891292801
Provider Name (Legal Business Name): FARHA NAZ EBADI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2018
Last Update Date: 11/29/2024
Certification Date: 11/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 PARNASSUS AVE
SAN FRANCISCO CA
94143-2206
US

IV. Provider business mailing address

521 PARNASSUS AVE
SAN FRANCISCO CA
94143-2206
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-1000
  • Fax: 415-476-4818
Mailing address:
  • Phone: 415-476-1000
  • Fax: 415-476-4818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberDO01113
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDO01113
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: