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General NPI Number Information
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NPI Number | 1114148525
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Entity Type | Organization
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Legal Business Name | SIRUS FARIVAR, M.D.
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 17822 BEACH BLVD STE 437
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-7181
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Country | US
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Telephone | 714-841-7878
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Fax |
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Provider Business Mailing Address
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Address Line | 17822 BEACH BLVD STE 437
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-7181
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Country | US
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Telephone | 714-841-7878
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | PAM CALDERON
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Credential |
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Telephone | 310-343-8884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State | CA
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