MEDICARE: SAFOORA FARJAMI D.C

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	111N00000X	Chiropractor	28228	CA

General Provider Information

NPI Number	:	1316083199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAFOORA FARJAMI D.C

Provider Business Mailing Address
First Line	:	166 N MOORPARK RD STE 301
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360-4437
Country	:	US
Telephone Number	:	805-371-5610
Fax Number	:	805-371-5611

Provider Business Practice Location Address
First Line	:	166 N MOORPARK RD STE 301
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360-4437
Country	:	US
Telephone Number	:	805-371-5610
Fax Number	:	805-371-5611

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

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	07/08/2007

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