Provider Demographics
NPI:1558487306
Name:FARIDI G SHERIEFF DPM INC
Entity Type:Organization
Organization Name:FARIDI G SHERIEFF DPM INC
Other - Org Name:FARIDI G SHERIEFF INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARIDI
Authorized Official - Middle Name:G
Authorized Official - Last Name:SHERIEFF
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:805-736-8818
Mailing Address - Street 1:509 EAST OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-6965
Mailing Address - Country:US
Mailing Address - Phone:805-736-8818
Mailing Address - Fax:805-736-9468
Practice Address - Street 1:509 E OCEAN AVE
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-6965
Practice Address - Country:US
Practice Address - Phone:805-736-8818
Practice Address - Fax:805-736-9468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric