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General NPI Number Information
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NPI Number | 1134291032
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Entity Type | Individual
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Provider Name | FARSHID MOOSSAZADEH M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 10/01/2020
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Provider Practice Location Address
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Address Line | 11633 HAWTHORNE BLVD SUITE 300
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City | HAWTHORNE
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State | CA
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Zip | 90250-2324
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Country | US
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Telephone | 310-355-1950
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Fax | 310-355-1957
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Provider Business Mailing Address
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Address Line | 11633 HAWTHORNE BLVD SUITE 300
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City | HAWTHORNE
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State | CA
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Zip | 90250-2321
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Country | US
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Telephone | 310-355-1950
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Fax | 310-355-1957
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | G790110
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License Number State | CA
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