Provider Demographics
NPI:1598534562
Name:MAGHOUL, FARIBA (FNP)
Entity Type:Individual
Prefix:MRS
First Name:FARIBA
Middle Name:
Last Name:MAGHOUL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 E RANDOLPH PL
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-2621
Mailing Address - Country:US
Mailing Address - Phone:562-714-4143
Mailing Address - Fax:
Practice Address - Street 1:224 E RANDOLPH PL
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2621
Practice Address - Country:US
Practice Address - Phone:562-714-4143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95025765363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily