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General NPI Number Information
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NPI Number | 1700294386
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Entity Type | Organization
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Legal Business Name | FARSHAD NOWZARI, MD INC
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Dates
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Enumeration Date | 07/28/2014
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Last Update Date | 07/28/2014
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Provider Practice Location Address
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Address Line | 1141 W REDONDO BEACH BLVD SUITE #303
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City | GARDENA
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State | CA
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Zip | 90247-3586
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Country | US
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Telephone | 310-538-2930
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Fax | 310-538-2932
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Provider Business Mailing Address
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Address Line | 1141 W REDONDO BEACH BLVD SUITE #303
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City | GARDENA
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State | CA
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Zip | 90247-3586
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Country | US
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Telephone | 310-538-2930
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Fax | 310-538-2932
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Authorized Official
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Title or Position | PHYSICIAN/ MANAGING PARTNER
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Name | DR. FARSHAD NOWZARI
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Credential | M.D.
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Telephone | 310-538-2930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | A75966
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License Number State | CA
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