MEDICARE: DR. RONALD DENIS FARRAN 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	174400000X	Specialist	C30866	CA

General Provider Information

NPI Number	:	1598776254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD DENIS FARRAN M.D,

Provider Business Mailing Address
First Line	:	23560 MADISON ST
Second Line	:	SUITE 205
City	:	TORRANCE
State	:	CA
Zip	:	90505-4708
Country	:	US
Telephone Number	:	310-530-8822
Fax Number	:	310-530-0288

Provider Business Practice Location Address
First Line	:	23560 MADISON ST
Second Line	:	SUITE 205
City	:	TORRANCE
State	:	CA
Zip	:	90505-4708
Country	:	US
Telephone Number	:	310-530-8822
Fax Number	:	310-530-0288

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

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	09/12/2007

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