MEDICARE: DR. BITA FARHADIAN 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	207V00000X	Obstetrics & Gynecology Physician	A106646	CA

General Provider Information

NPI Number	:	1548409113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BITA FARHADIAN M.D

Provider Business Mailing Address
First Line	:	315 N CITRUS AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-2633
Country	:	US
Telephone Number	:	310-990-2482
Fax Number	:

Provider Business Practice Location Address
First Line	:	315 N CITRUS AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90036-2633
Country	:	US
Telephone Number	:	310-990-2482
Fax Number	:

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

Provider Enumeration Date	:	02/05/2009
Last Update Date	:	04/26/2022

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