Provider Demographics
NPI:1003812348
Name:GHARAI, FARIBA (MD)
Entity Type:Individual
Prefix:DR
First Name:FARIBA
Middle Name:
Last Name:GHARAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3828 SCHAUFELE AVE STE 340
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-1793
Mailing Address - Country:US
Mailing Address - Phone:657-241-9051
Mailing Address - Fax:714-665-4602
Practice Address - Street 1:3828 SCHAUFELE AVE STE 340
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-1793
Practice Address - Country:US
Practice Address - Phone:657-241-9051
Practice Address - Fax:714-665-4602
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94805208600000X, 208G00000X
KY38145208600000X
CAC55954208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC55954Medicaid
FL000147700Medicaid
FLP00671276OtherMEDICARE RAILROAD
FLP00671276OtherRAILROAD MEDICARE
FLAX602ZMedicare PIN
CW620AMedicare PIN