Healthcare Provider Details

I. General information

NPI: 1659627115
Provider Name (Legal Business Name): DINA FARSHIDI BIERMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2012
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1811 WILSHIRE BLVD STE 110
SANTA MONICA CA
90403-5626
US

IV. Provider business mailing address

630 BIENVENEDA AVE
PACIFIC PALISADES CA
90272-3337
US

V. Phone/Fax

Practice location:
  • Phone: 310-829-0260
  • Fax: 310-829-0263
Mailing address:
  • Phone: 714-287-5284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberA124111
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: