Provider Demographics
NPI:1619057684
Name:FARID, SAMY F (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMY
Middle Name:F
Last Name:FARID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SAMY
Other - Middle Name:F
Other - Last Name:FARID
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD INC
Mailing Address - Street 1:1729 WEST AVE J
Mailing Address - Street 2:101
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-5501
Mailing Address - Country:US
Mailing Address - Phone:661-949-5193
Mailing Address - Fax:661-949-6948
Practice Address - Street 1:1729 WEST AVE J
Practice Address - Street 2:101
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-5501
Practice Address - Country:US
Practice Address - Phone:661-949-5193
Practice Address - Fax:661-949-6948
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA045390174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist