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NPI Code Detail

MEDICARE: FARAH MASOUMI

MEDICARE:   FARAH  MASOUMI
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
11041C0700XClinical Social WorkerLCSW25694CA

General Provider Information

NPI Number : 1518035039
Entity Type Code : Individual
Provider Name (Legal Business Name) : FARAH MASOUMI
Provider Business Mailing Address
First Line : PO BOX 2007
Second Line :
City : LONG BEACH
State : CA
Zip : 90801-2007
Country : US
Telephone Number : 562-400-0017
Fax Number :
Provider Business Practice Location Address
First Line : 3711 LONG BEACH BLVD OFC 4075
Second Line :
City : LONG BEACH
State : CA
Zip : 90807-3315
Country : US
Telephone Number : 562-400-0017
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2006
Last Update Date : 05/19/2023

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Directions to “ FARAH MASOUMI ” Practice Location

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