Healthcare Provider Details

I. General information

NPI: 1528256823
Provider Name (Legal Business Name): HOUSHANG FARHADIAN, MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2007
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25425 ORCHARD VILLAGE RD
SANTA CLARITA CA
91355-2955
US

IV. Provider business mailing address

3346 RED ROSE DR
ENCINO CA
91436-4212
US

V. Phone/Fax

Practice location:
  • Phone: 661-259-6996
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberA31355
License Number StateCA

VIII. Authorized Official

Name: DR. HOUSHANG FARHADIAN
Title or Position: OWNER
Credential: M.D.
Phone: 661-259-6996