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1861446015

NPI Code Detail

MEDICARE: KAMBIZ FARBAKHSH MD

MEDICARE: KAMBIZ FARBAKHSH 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	207R00000X	Internal Medicine Physician	42501	MN
2	207R00000X	Internal Medicine Physician	63068	AZ
3	207R00000X	Internal Medicine Physician	C55570	CA
4	207R00000X	Internal Medicine Physician	CDR.0002692	CO
5	207RN0300X	Nephrology Physician	42501	MN
6	207R00000X	Internal Medicine Physician	44614	OK
7	207R00000X	Internal Medicine Physician	43959-20	WI
8	207R00000X	Internal Medicine Physician	35.138059	OH

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
2	CDR.0002692	OTHER	CO	LICENSE

General Provider Information

NPI Number	:	1861446015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAMBIZ FARBAKHSH MD

Provider Business Mailing Address
First Line	:	8362 TAMARACK VLG STE 119401
Second Line	:
City	:	WOODBURY
State	:	MN
Zip	:	55125-3392
Country	:	US
Telephone Number	:	866-433-8432
Fax Number	:	866-433-8432

Provider Business Practice Location Address
First Line	:	4650 LINCOLN BLVD
Second Line	:
City	:	MARINA DEL REY
State	:	CA
Zip	:	90292-6306
Country	:	US
Telephone Number	:	310-823-8911
Fax Number	:	310-823-8911

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

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	05/27/2026

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Directions to “ KAMBIZ FARBAKHSH MD” Practice Location

Language	Start Address	Practice Location

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