MEDICARE: DR. FARZIN SEAN FARSHIDI DDS MD

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DDS63573	CA

General Provider Information

NPI Number	:	1750676755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FARZIN SEAN FARSHIDI DDS MD

Provider Business Mailing Address
First Line	:	17452 IRVINE BLVD STE 100
Second Line	:
City	:	TUSTIN
State	:	CA
Zip	:	92780-3031
Country	:	US
Telephone Number	:	949-310-5888
Fax Number	:

Provider Business Practice Location Address
First Line	:	17452 IRVINE BLVD STE 100
Second Line	:
City	:	TUSTIN
State	:	CA
Zip	:	92780-3031
Country	:	US
Telephone Number	:	949-310-5888
Fax Number	:

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

Provider Enumeration Date	:	06/17/2011
Last Update Date	:	09/03/2024

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