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NPI Code Detail

MEDICARE: FARNAZ MOHAMMADI

MEDICARE: FARNAZ MOHAMMADI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist113164CA

General Provider Information

NPI Number : 1043146798
Entity Type Code : Individual
Provider Name (Legal Business Name) : FARNAZ MOHAMMADI
Provider Business Mailing Address
First Line : 1401 DOLLIVER ST STE 202
Second Line :
City : PISMO BEACH
State : CA
Zip : 93449-2200
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3870 BROAD ST STE 1
Second Line :
City : SAN LUIS OBISPO
State : CA
Zip : 93401-7172
Country : US
Telephone Number : 805-202-4988
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2026
Last Update Date : 06/22/2026

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Directions to “ FARNAZ MOHAMMADI ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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