Provider Demographics
NPI:1033522404
Name:PIRAYESH, FARNAZ (DO)
Entity Type:Individual
Prefix:
First Name:FARNAZ
Middle Name:
Last Name:PIRAYESH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:FARNAZ
Other - Middle Name:
Other - Last Name:BAQAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:5075 S BRADLEY RD STE 131
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-5077
Mailing Address - Country:US
Mailing Address - Phone:805-332-8155
Mailing Address - Fax:805-332-8156
Practice Address - Street 1:5075 S BRADLEY RD STE 131
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-5077
Practice Address - Country:US
Practice Address - Phone:805-332-8155
Practice Address - Fax:805-332-8156
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A14362207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine