MEDICARE: AMIR FARIZANI 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	390200000X	Student in an Organized Health Care Education/Training Program
2	207Q00000X	Family Medicine Physician	A169679	CA

General Provider Information

NPI Number	:	1407387988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMIR FARIZANI M.D.

Provider Business Mailing Address
First Line	:	5055 CALIFORNIA AVE STE 300
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93309-0712
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2929 WESLAYAN ST
Second Line	:	APT 2902
City	:	HOUSTON
State	:	TX
Zip	:	77027-5433
Country	:	US
Telephone Number	:	832-744-1797
Fax Number	:

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

Provider Enumeration Date	:	03/25/2017
Last Update Date	:	12/15/2021

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