Provider Demographics
NPI:1043795073
Name:YAZDANFAR, FARZAM (DC)
Entity Type:Individual
Prefix:DR
First Name:FARZAM
Middle Name:
Last Name:YAZDANFAR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12360 FIRESTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-4324
Mailing Address - Country:US
Mailing Address - Phone:866-733-5924
Mailing Address - Fax:
Practice Address - Street 1:12360 FIRESTONE BLVD
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-4324
Practice Address - Country:US
Practice Address - Phone:866-733-5924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34283111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor