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General NPI Number Information
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NPI Number | 1750962981
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Entity Type | Organization
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Legal Business Name | MISHEL FARASATPOUR MD INC
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Dates
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Enumeration Date | 04/19/2021
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Last Update Date | 04/19/2021
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Provider Practice Location Address
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Address Line | 10966 W PICO BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90064-2115
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Country | US
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Telephone | 310-666-3288
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 55517
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City | SHERMAN OAKS
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State | CA
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Zip | 91413-0517
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Country | US
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Telephone | 310-666-3288
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Fax | 424-317-4416
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MISHEL FARASATPOUR
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Credential | MD
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Telephone | 310-666-3288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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