Provider Demographics
NPI:1346388600
Name:KERENDIAN, FARZIN (DO)
Entity Type:Individual
Prefix:
First Name:FARZIN
Middle Name:
Last Name:KERENDIAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10464
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90213-3464
Mailing Address - Country:US
Mailing Address - Phone:310-274-4900
Mailing Address - Fax:661-327-4404
Practice Address - Street 1:2080 CENTURY PARK E STE 607
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067-2009
Practice Address - Country:US
Practice Address - Phone:310-274-4900
Practice Address - Fax:310-613-6137
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A76472086S0122X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A7647Medicare PIN
CAH55932Medicare UPIN