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General NPI Number Information
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NPI Number | 1164549598
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Entity Type | Organization
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Legal Business Name | FARAH FERRER MD MEDICAL GROUP INC
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 06/13/2023
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Provider Practice Location Address
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Address Line | 5406 E BEVERLY BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90022-2208
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Country | US
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Telephone | 323-213-3605
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Fax |
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Provider Business Mailing Address
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Address Line | 5406 E BEVERLY BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90022-2208
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Country | US
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Telephone | 323-573-6010
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | FARAH FERRER
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Credential | MD
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Telephone | 818-854-6971
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0015X
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Taxonomy Name | Psychosomatic Medicine Physician
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License Number |
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License Number State |
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