=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376711697
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HASHEM M. FARR, M.D., A PROFESSIONAL CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/20/2008
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2375 FOREST AVE
-----------------------------------------------------
City | SAN JOSE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95128
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-297-7077
-----------------------------------------------------
Fax | 408-297-7080
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2375 FOREST AVE
-----------------------------------------------------
City | SAN JOSE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95128
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-297-7077
-----------------------------------------------------
Fax | 408-297-7080
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. HASHEM M FARR
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 408-297-7077
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0100X
-----------------------------------------------------
Taxonomy Name | Gastroenterology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------