MEDICARE: DR. FARZIN R FARHAN DDS

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	122300000X	Dentist	42467	CA

General Provider Information

NPI Number	:	1184778292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FARZIN R FARHAN DDS

Provider Business Mailing Address
First Line	:	2822 S WESTERN AVENUE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90018-3032
Country	:	US
Telephone Number	:	323-734-9600
Fax Number	:	323-734-9300

Provider Business Practice Location Address
First Line	:	2822 S WESTERN AVENUE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90018-3032
Country	:	US
Telephone Number	:	323-734-9600
Fax Number	:	323-734-9300

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

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	06/30/2016

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