Provider Demographics
NPI:1043394653
Name:JOSE B FARINHA MD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:JOSE B FARINHA MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:B
Authorized Official - Last Name:FARINHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-726-0602
Mailing Address - Street 1:PO BOX 801463
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91380-1463
Mailing Address - Country:US
Mailing Address - Phone:661-430-0940
Mailing Address - Fax:661-295-0862
Practice Address - Street 1:5305 E BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-2103
Practice Address - Country:US
Practice Address - Phone:323-726-0602
Practice Address - Fax:323-726-0881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA24184207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA24184OtherPRES. STATE LICENSE#
CAD87572Medicare UPIN
CA00A241842Medicaid
CAD87572Medicare UPIN