MEDICARE: MS. NILOFAR FAGHIHNIA D.P.M.

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	213ES0103X	Foot & Ankle Surgery Podiatrist	EL-1756	CA
2	207X00000X	Orthopaedic Surgery Physician	E4935	CA

General Provider Information

NPI Number	:	1962660928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NILOFAR FAGHIHNIA D.P.M.

Provider Business Mailing Address
First Line	:	425 W BEECH ST UNIT 1306
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-2961
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 W BEECH ST UNIT 1306
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-2961
Country	:	US
Telephone Number	:	916-601-7193
Fax Number	:

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

Provider Enumeration Date	:	05/27/2008
Last Update Date	:	12/06/2021

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