Provider Demographics
NPI:1598889008
Name:FARABI, ALIREZA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALIREZA
Middle Name:
Last Name:FARABI
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:PO BOX 370141
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89137-0141
Mailing Address - Country:US
Mailing Address - Phone:702-383-2691
Mailing Address - Fax:702-388-4114
Practice Address - Street 1:701 SHADOW LANE # 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106
Practice Address - Country:US
Practice Address - Phone:702-383-2691
Practice Address - Fax:702-388-4114
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV13143207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV13143OtherMEDICAL LICENSE
NVCS18077OtherPHARMACY LICENSE
NVFF1336937OtherDEA CERTIFICATE