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General NPI Number Information
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NPI Number | 1154467561
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Entity Type | Organization
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Legal Business Name | ABDUL S. FARZIN M.D., INC
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 36243 INLAND VALLEY DR SUITE 240
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City | WILDOMAR
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State | CA
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Zip | 92595-9549
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Country | US
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Telephone | 951-600-0640
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Fax | 951-600-8142
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Provider Business Mailing Address
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Address Line | 36243 INLAND VALLEY DR SUITE 240
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City | WILDOMAR
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State | CA
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Zip | 92595-9549
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Country | US
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Telephone | 951-600-0640
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Fax | 951-600-8142
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ABDUL S. FARZIN
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Credential | M.D.
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Telephone | 951-600-0640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A53334
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License Number State | CA
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