Provider Demographics
NPI:1548771330
Name:FARBOD FARMAND DO A PROFESSIONAL CORP
Entity Type:Organization
Organization Name:FARBOD FARMAND DO A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FARBOD
Authorized Official - Middle Name:
Authorized Official - Last Name:FARMAND
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:949-290-2701
Mailing Address - Street 1:23141 VERDUGO DR STE 201
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1341
Mailing Address - Country:US
Mailing Address - Phone:949-215-5055
Mailing Address - Fax:949-326-5099
Practice Address - Street 1:23141 VERDUGO DR STE 201
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1341
Practice Address - Country:US
Practice Address - Phone:949-290-2701
Practice Address - Fax:949-326-5099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-19
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center