Healthcare Provider Details

I. General information

NPI: 1912067943
Provider Name (Legal Business Name): DIANA VEIT FARNSWORTH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5620 WILBUR AVE SUITE 305
TARZANA CA
91356-1351
US

IV. Provider business mailing address

5620 WILBUR AVE SUITE 305
TARZANA CA
91356-1351
US

V. Phone/Fax

Practice location:
  • Phone: 818-708-7116
  • Fax: 818-708-8250
Mailing address:
  • Phone: 818-708-7116
  • Fax: 818-708-8250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG31412
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: