Provider Demographics
NPI:1487833422
Name:FARHAD ZANGENEH MD PC
Entity Type:Organization
Organization Name:FARHAD ZANGENEH MD PC
Other - Org Name:ENDOCRINE DIABETES & OSTEROPOROSIS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FARHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ZANGENEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-444-4450
Mailing Address - Street 1:46090 LAKE CENTER PLZ
Mailing Address - Street 2:SUITE 106
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-5876
Mailing Address - Country:US
Mailing Address - Phone:703-444-4450
Mailing Address - Fax:703-444-4410
Practice Address - Street 1:46090 LAKE CENTER PLZ
Practice Address - Street 2:SUITE 106
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-5876
Practice Address - Country:US
Practice Address - Phone:703-444-4450
Practice Address - Fax:703-444-4410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101233721207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VADE0220OtherRAILROAD
VAC09388Medicare PIN
H16808Medicare UPIN