Provider Demographics
NPI:1104038744
Name:RONALD D. FARRAN, M.D., INC.
Entity Type:Organization
Organization Name:RONALD D. FARRAN, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:FARRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-530-8822
Mailing Address - Street 1:23560 MADISON ST
Mailing Address - Street 2:#205
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4708
Mailing Address - Country:US
Mailing Address - Phone:310-530-8822
Mailing Address - Fax:310-530-0288
Practice Address - Street 1:23560 MADISON ST
Practice Address - Street 2:#205
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4708
Practice Address - Country:US
Practice Address - Phone:310-530-8822
Practice Address - Fax:310-530-0288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC30866174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty