Provider Demographics
NPI:1083809966
Name:DADFARMAY, SINA (MD)
Entity Type:Individual
Prefix:
First Name:SINA
Middle Name:
Last Name:DADFARMAY
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 1:20911 EARL ST
Mailing Address - Street 2:STE 200
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4353
Mailing Address - Country:US
Mailing Address - Phone:310-488-4232
Mailing Address - Fax:310-644-7198
Practice Address - Street 1:4700 WATERS AVE
Practice Address - Street 2:MEMORIAL HEALTH IM EDU
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404
Practice Address - Country:US
Practice Address - Phone:912-350-7573
Practice Address - Fax:912-350-7270
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2017-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GATL002792207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine