Provider Demographics
NPI:1164503330
Name:AHAMED, FARAH KARIM (DO)
Entity Type:Individual
Prefix:DR
First Name:FARAH
Middle Name:KARIM
Last Name:AHAMED
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:FARAH
Other - Middle Name:MUNEER
Other - Last Name:KARIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:10 VIA PERGOLA
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275
Mailing Address - Country:US
Mailing Address - Phone:310-541-3582
Mailing Address - Fax:310-618-1241
Practice Address - Street 1:2382 CRENSHAW BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501
Practice Address - Country:US
Practice Address - Phone:310-618-9200
Practice Address - Fax:310-618-1241
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO1205207R00000X
CA20A10100207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRES000Medicare UPIN