Provider Demographics
NPI:1033113006
Name:FARINHA, PEDRO L (MD)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:L
Last Name:FARINHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 N WINDSONG DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-1222
Mailing Address - Country:US
Mailing Address - Phone:928-910-7010
Mailing Address - Fax:928-910-7011
Practice Address - Street 1:3221 N WINDSONG DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-1222
Practice Address - Country:US
Practice Address - Phone:928-910-7010
Practice Address - Fax:928-910-7011
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-08
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ68674207R00000X
CAA63404207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00A634040OtherBLUE CROSS
CA00A634040Medicaid
00A634040OtherBLUE SHIELD
625046OtherAHI HEALTH LINK
93555B082OtherTRIWEST/TRICARE
A63404OtherIMG
00A634040OtherCOMMERCIAL INSURANCE
0616650001OtherDME
110153488OtherRAILROAD MEDICARE
CA0103OtherJOHN DEERE
93555B082OtherTRIWEST/TRICARE
0616650001OtherDME
CA00A634040Medicaid