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General NPI Number Information
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NPI Number | 1922401215
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Entity Type | Organization
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Legal Business Name | ELAHEH FARHADIAN MD INC.
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Dates
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Enumeration Date | 10/01/2014
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Last Update Date | 01/10/2019
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Provider Practice Location Address
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Address Line | 17447 CHATSWORTH STREET
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City | GRANADA HILLS
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State | CA
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Zip | 91344
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Country | US
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Telephone | 818-923-5702
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Fax | 818-923-5703
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Provider Business Mailing Address
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Address Line | 17447 CHATSWORTH STREET
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City | GRANADA HILLS
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State | CA
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Zip | 91344
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Country | US
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Telephone | 818-923-5702
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Fax | 818-923-5703
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Authorized Official
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Title or Position | CEO
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Name | ELAHEH FARHADIAN
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Credential | MD
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Telephone | 818-923-5702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A100453
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License Number State | CA
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