Provider Demographics
NPI:1578771903
Name:NOOSHIN FARAHMAND, M.D., INC.
Entity Type:Organization
Organization Name:NOOSHIN FARAHMAND, M.D., INC.
Other - Org Name:NOOSHIN FARAHMAND, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NOOSHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FARAHMAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-991-8254
Mailing Address - Street 1:1751 W ROMNEYA DR STE A
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-1815
Mailing Address - Country:US
Mailing Address - Phone:714-991-8254
Mailing Address - Fax:714-991-8241
Practice Address - Street 1:1751 W ROMNEYA DR STE A
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1815
Practice Address - Country:US
Practice Address - Phone:714-991-8254
Practice Address - Fax:714-991-8241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA56465Medicare ID - Type Unspecified