Healthcare Provider Details

I. General information

NPI: 1487229548
Provider Name (Legal Business Name): FARBOD FARHANG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2021
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 BLUEBELL RD
CEDAR FALLS IA
50613-6328
US

IV. Provider business mailing address

226 BLUEBELL RD
CEDAR FALLS IA
50613-6328
US

V. Phone/Fax

Practice location:
  • Phone: 319-272-5000
  • Fax: 319-575-5855
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberDO-06583
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: