MEDICARE: CHARLES FRANK FARTHING MD

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
1	207RI0200X	Infectious Disease Physician	A52857	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053305979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES FRANK FARTHING MD

Provider Business Mailing Address
First Line	:	1001 N MARTEL AVE
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90046-6611
Country	:	US
Telephone Number	:	323-436-5019
Fax Number	:	323-436-5034

Provider Business Practice Location Address
First Line	:	99 N LA CIENEGA BLVD
Second Line	:	SUITE #200
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2222
Country	:	US
Telephone Number	:	310-657-9353
Fax Number	:	310-657-9367

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	07/08/2007

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Directions to “ CHARLES FRANK FARTHING MD” Practice Location

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