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NPI Code Detail

MEDICARE: DR. KEYVAN FARHAD ND

MEDICARE: DR. KEYVAN FARHAD ND
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
1133V00000XRegistered Dietitian86016431CA
2175F00000XNaturopathND1333CA

General Provider Information

NPI Number : 1225775612
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEYVAN FARHAD ND
Provider Business Mailing Address
First Line : 113 WATERWORKS WAY STE 155
Second Line :
City : IRVINE
State : CA
Zip : 92618-3163
Country : US
Telephone Number : 949-612-9090
Fax Number :
Provider Business Practice Location Address
First Line : 113 WATERWORKS WAY STE 155
Second Line :
City : IRVINE
State : CA
Zip : 92618-3163
Country : US
Telephone Number : 949-612-9090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2022
Last Update Date : 10/08/2023

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