1861592420 NPI number — DR. ARASH FARHADIAN D.D.S

Table of content: DR. ARASH FARHADIAN D.D.S (NPI 1861592420)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861592420 NPI number — DR. ARASH FARHADIAN D.D.S

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FARHADIAN
Provider First Name:
ARASH
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.D.S
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861592420
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
400 N SKYEWIAY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90049-2845
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-709-3477
Provider Business Mailing Address Fax Number:
818-788-4388

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17175 VENTURA BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ENCINO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91316-4050
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-788-3488
Provider Business Practice Location Address Fax Number:
818-788-4388
Provider Enumeration Date:
09/24/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  47615 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)