MEDICARE: SHAHRIAR FARZAD M.D., A MEDICAL CORPORATION

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	207W00000X	Ophthalmology Physician

General Provider Information

NPI Number	:	1508816158
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHAHRIAR FARZAD M.D., A MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	150 N. ROBERTSON BLVD.
Second Line	:	SUITE #316
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2145
Country	:	US
Telephone Number	:	310-247-8282
Fax Number	:	310-247-1418

Provider Business Practice Location Address
First Line	:	150 N. ROBERTSON BLVD.
Second Line	:	SUITE #316
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2145
Country	:	US
Telephone Number	:	310-247-8282
Fax Number	:	310-247-1418

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	PARI FARZAD
Credential	:
Telephone Number	:	310-247-8282

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	02/15/2012

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