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General NPI Number Information
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NPI Number | 1366617300
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Entity Type | Individual
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Provider Name | FARAHNAZ DASHTGERD
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Gender | Female
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 04/29/2008
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Provider Practice Location Address
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Address Line | 14471 CHAMBERS RD SUITE 103
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City | TUSTIN
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State | CA
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Zip | 92780-6965
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Country | US
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Telephone | 949-378-3993
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Fax | 949-340-1572
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Provider Business Mailing Address
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Address Line | 14471 CHAMBERS RD SUITE 103
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City | TUSTIN
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State | CA
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Zip | 92780-6965
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Country | US
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Telephone | 949-378-3993
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Fax | 949-340-1572
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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 | 246W00000X
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Taxonomy Name | Cardiology Technician
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License Number |
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License Number State |
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