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General NPI Number Information
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NPI Number | 1255347670
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Entity Type | Organization
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Legal Business Name | MAHNAZ FARAHMAND, MD. INC
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 41715 WINCHESTER RD 203
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City | TEMECULA
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State | CA
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Zip | 92590-4808
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Country | US
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Telephone | 951-693-9285
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Fax | 951-587-9081
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Provider Business Mailing Address
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Address Line | PO BOX 1264
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City | TEMECULA
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State | CA
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Zip | 92593-1264
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Country | US
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Telephone | 951-693-9285
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Fax | 951-587-9081
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS MAHNAZ FARAHMAND
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Credential | M.D.
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Telephone | 951-693-9285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A63290
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License Number State | CA
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