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General NPI Number Information
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NPI Number | 1598196396
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Entity Type | Organization
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Legal Business Name | FARIBA AKHAVON MD PC
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Dates
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Enumeration Date | 12/03/2013
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Last Update Date | 01/27/2014
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Provider Practice Location Address
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Address Line | 316 W ACEQUIA AVE
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City | VISALIA
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State | CA
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Zip | 93291-6232
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Country | US
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Telephone | 559-688-8880
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Fax | 559-688-8877
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Provider Business Mailing Address
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Address Line | 316 W ACEQUIA AVE
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City | VISALIA
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State | CA
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Zip | 93291-6232
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Country | US
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Telephone | 559-688-8880
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Fax | 559-688-8877
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. FARIBA AKHAVON
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Credential | M.D.
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Telephone | 559-688-8880
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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 | A112198
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License Number State | CA
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