Healthcare Provider Details

I. General information

NPI: 1982686549
Provider Name (Legal Business Name): MEHRDAD FARHANG MEHR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W ARRELLAGA ST STE E
SANTA BARBARA CA
93101-5948
US

IV. Provider business mailing address

27 W ANAPAMU ST # 433
SANTA BARBARA CA
93101-3107
US

V. Phone/Fax

Practice location:
  • Phone: 617-414-5170
  • Fax: 617-414-3803
Mailing address:
  • Phone: 805-705-1608
  • Fax: 805-249-1299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number152593
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberC55390
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number152593
License Number StateMA
# 4
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC55390
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: