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NPI Code Detail

MEDICARE: ROXANA FARAHANI

MEDICARE: ROXANA FARAHANI
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
1235Z00000XSpeech-Language PathologistSP20258CA

General Provider Information

NPI Number : 1396098141
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROXANA FARAHANI
Provider Business Mailing Address
First Line : 5761 BUCKINGHAM PKWY
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-6515
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5761 BUCKINGHAM PKWY
Second Line :
City : CULVER CITY
State : CA
Zip : 90230-6515
Country : US
Telephone Number : 310-649-6199
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2012
Last Update Date : 10/17/2012

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Directions to “ ROXANA FARAHANI ” Practice Location

Language Start Address Practice Location
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