Provider Demographics
NPI:1588005474
Name:OSMANI, FARAAZ ALI (MD)
Entity Type:Individual
Prefix:
First Name:FARAAZ
Middle Name:ALI
Last Name:OSMANI
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 1:16133 VENTURA BLVD
Mailing Address - Street 2:STE 360
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2426
Mailing Address - Country:US
Mailing Address - Phone:818-986-6009
Mailing Address - Fax:818-239-4239
Practice Address - Street 1:16133 VENTURA BLVD
Practice Address - Street 2:STE 360
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2426
Practice Address - Country:US
Practice Address - Phone:818-986-6009
Practice Address - Fax:818-239-4239
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-09
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA142675207R00000X
MI4301103780207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine