Provider Demographics
NPI:1215035415
Name:FARID, HANY (MD)
Entity Type:Individual
Prefix:
First Name:HANY
Middle Name:
Last Name:FARID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2129 QUEENSBOROUGH LN
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1364
Mailing Address - Country:US
Mailing Address - Phone:818-838-4544
Mailing Address - Fax:818-838-7565
Practice Address - Street 1:11600 INDIAN HILLS RD
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1225
Practice Address - Country:US
Practice Address - Phone:818-838-4544
Practice Address - Fax:818-838-7565
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG080565208600000X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG65211Medicare UPIN