MEDICARE: ABDUL S. FARZIN M.D., INC

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	207Q00000X	Family Medicine Physician	A53334	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A53334	OTHER	CA	STATE LICENSE

General Provider Information

NPI Number	:	1154467561
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABDUL S. FARZIN M.D., INC

Provider Business Mailing Address
First Line	:	36243 INLAND VALLEY DR
Second Line	:	SUITE 240
City	:	WILDOMAR
State	:	CA
Zip	:	92595-9549
Country	:	US
Telephone Number	:	951-600-0640
Fax Number	:	951-600-8142

Provider Business Practice Location Address
First Line	:	36243 INLAND VALLEY DR
Second Line	:	SUITE 240
City	:	WILDOMAR
State	:	CA
Zip	:	92595-9549
Country	:	US
Telephone Number	:	951-600-0640
Fax Number	:	951-600-8142

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. ABDUL S. FARZIN
Credential	:	M.D.
Telephone Number	:	951-600-0640

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	03/07/2023

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Directions to “ABDUL S. FARZIN M.D., INC ” Practice Location

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