Provider Demographics
NPI:1225059108
Name:NOWZARI, FARHAD B (MD)
Entity Type:Individual
Prefix:
First Name:FARHAD
Middle Name:B
Last Name:NOWZARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3400 LOMITA BLVD
Mailing Address - Street 2:STE 502
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4988
Mailing Address - Country:US
Mailing Address - Phone:310-921-1100
Mailing Address - Fax:310-921-9922
Practice Address - Street 1:3400 LOMITA BLVD
Practice Address - Street 2:STE 502
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4988
Practice Address - Country:US
Practice Address - Phone:310-921-1100
Practice Address - Fax:310-921-9922
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA71464208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADG3479OtherMCRR GROUP PTAN
CA203177408OtherTAX ID
CAP00728133OtherMEDICARE RR
CADG3479OtherMCRR GROUP PTAN
CAP00728133OtherMEDICARE RR