Healthcare Provider Details

I. General information

NPI: 1205087079
Provider Name (Legal Business Name): NILOOFAR LEYLA FARMANI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2008
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 NE NEFF RD
BEND OR
97701-6337
US

IV. Provider business mailing address

5451 LA PALMA AVE SUITE 25
LA PALMA CA
90623-1728
US

V. Phone/Fax

Practice location:
  • Phone: 541-706-7735
  • Fax:
Mailing address:
  • Phone: 714-670-1340
  • Fax: 714-443-3780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberA105243
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA105243
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: