MEDICARE: FEREIDOUN BAKHSH TEHRANI 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	207Q00000X	Family Medicine Physician	MD039033L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770567901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FEREIDOUN BAKHSH TEHRANI MD

Provider Business Mailing Address
First Line	:	6521 FRANKFORD AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19135-2538
Country	:	US
Telephone Number	:	215-624-2303
Fax Number	:	215-624-2577

Provider Business Practice Location Address
First Line	:	6521 FRANKFORD AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19135
Country	:	US
Telephone Number	:	215-624-2303
Fax Number	:	215-624-2577

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

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	01/16/2020

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