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General NPI Number Information
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NPI Number | 1013313337
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Entity Type | Organization
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Legal Business Name | FARAHKHAN,MD,INC
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Dates
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Enumeration Date | 11/13/2014
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Last Update Date | 11/13/2014
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Provider Practice Location Address
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Address Line | 21 TAMAL VISTA BLVD 224
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City | CORTE MADERA
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State | CA
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Zip | 94925-1130
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Country | US
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Telephone | 415-999-1259
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Fax | 415-366-2020
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Provider Business Mailing Address
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Address Line | 21 TAMAL VISTA BLVD 224
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City | CORTE MADERA
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State | CA
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Zip | 94925-1130
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Country | US
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Telephone | 415-999-1259
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Fax | 415-366-2020
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Authorized Official
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Title or Position | PRESIDENT
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Name | FARAH KHAN
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Credential | MD
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Telephone | 415-999-1259
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A41384
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License Number State | CA
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