Provider Demographics
NPI:1407086390
Name:SARRAFIAN, PEYMAN (MD)
Entity Type:Individual
Prefix:
First Name:PEYMAN
Middle Name:
Last Name:SARRAFIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 WESTWIND DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3055
Mailing Address - Country:US
Mailing Address - Phone:661-327-9617
Mailing Address - Fax:
Practice Address - Street 1:1800 WESTWIND DR
Practice Address - Street 2:SUITE 301
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3055
Practice Address - Country:US
Practice Address - Phone:661-327-9617
Practice Address - Fax:661-327-5701
Is Sole Proprietor?:No
Enumeration Date:2009-07-25
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA109109173000000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A109109Medicare PIN