Healthcare Provider Details

I. General information

NPI: 1598845976
Provider Name (Legal Business Name): ARTA FARAHMAND DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 06/19/2020
Certification Date: 06/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23326 HAWTHORNE BLVD STE 220
TORRANCE CA
90505-3757
US

IV. Provider business mailing address

23326 HAWTHORNE BLVD STE 220
TORRANCE CA
90505-3757
US

V. Phone/Fax

Practice location:
  • Phone: 310-373-3501
  • Fax: 310-791-2615
Mailing address:
  • Phone: 310-373-3501
  • Fax: 310-791-2615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number36920
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: