MEDICARE: DR. KAYVEN M FARSHAD 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	207L00000X	Anesthesiology Physician	R74993	AZ
2	207R00000X	Internal Medicine Physician	R74993	AZ
3	207LP2900X	Pain Medicine (Anesthesiology) Physician	59113	AZ

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	:	1841678307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAYVEN M FARSHAD MD

Provider Business Mailing Address
First Line	:	4881 E GRANT RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-2704
Country	:	US
Telephone Number	:	520-829-6776
Fax Number	:	520-829-6661

Provider Business Practice Location Address
First Line	:	7140 E ROSEWOOD ST STE 110
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85710-1346
Country	:	US
Telephone Number	:	520-318-6035
Fax Number	:	520-795-9953

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

Provider Enumeration Date	:	05/15/2015
Last Update Date	:	01/24/2023

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