Provider Demographics
NPI:1609039056
Name:FARSHID PAYDAR MD PC
Entity Type:Organization
Organization Name:FARSHID PAYDAR MD PC
Other - Org Name:THE EYE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FARSHID
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYDAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-203-9600
Mailing Address - Street 1:401 S CALVARY WAY STE D
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-4165
Mailing Address - Country:US
Mailing Address - Phone:928-649-2600
Mailing Address - Fax:928-634-7847
Practice Address - Street 1:401 S CALVARY WAY STE D
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-4165
Practice Address - Country:US
Practice Address - Phone:928-649-2600
Practice Address - Fax:928-634-7847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ03C0001310OtherCMS CERTIFICATION NO
AZ525394Medicaid