MEDICARE: FAROOQUE AND ASSOCIATES INC.

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	364SP0808X	Psychiatric/Mental Health Clinical Nurse Specialist

General Provider Information

NPI Number	:	1730841552
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAROOQUE AND ASSOCIATES INC.

Provider Business Mailing Address
First Line	:	1654 MIDDLETON PL
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90062-1033
Country	:	US
Telephone Number	:	310-985-1828
Fax Number	:

Provider Business Practice Location Address
First Line	:	1654 MIDDLETON PL
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90062-1033
Country	:	US
Telephone Number	:	310-985-1828
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FAROOQUE AZAM
Credential	:	NURSE PRACTITIONER
Telephone Number	:	310-985-1828

Provider Enumeration Date	:	10/08/2021
Last Update Date	:	04/02/2025

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