MEDICARE: DR. FARID BESHARAT M.D.

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	207RP1001X	Pulmonary Disease Physician	A49504	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	:	1366548620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FARID BESHARAT M.D.

Provider Business Mailing Address
First Line	:	1400 S GRAND AVE
Second Line	:	STE 815
City	:	LOS ANGELES
State	:	CA
Zip	:	90015-3068
Country	:	US
Telephone Number	:	310-914-9150
Fax Number	:	310-914-9705

Provider Business Practice Location Address
First Line	:	1400 S GRAND AVE
Second Line	:	STE 815
City	:	LOS ANGELES
State	:	CA
Zip	:	90015-3068
Country	:	US
Telephone Number	:	310-914-9150
Fax Number	:	310-914-9705

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

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	10/23/2018

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