Healthcare Provider Details

I. General information

NPI: 1841499571
Provider Name (Legal Business Name): DR. FARIBORZ AFRAMIYAN FARNAD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13320 RIVERSIDE DR STE 110
SHERMAN OAKS CA
91423-2519
US

IV. Provider business mailing address

13320 RIVERSIDE DR STE 110
SHERMAN OAKS CA
91423-2519
US

V. Phone/Fax

Practice location:
  • Phone: 818-989-4100
  • Fax: 818-538-8808
Mailing address:
  • Phone: 818-989-4100
  • Fax: 818-538-8808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number50460
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: