Provider Demographics
NPI:1629012323
Name:FARINACCI, JOHN FRANCIS JR (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:FRANCIS
Last Name:FARINACCI
Suffix:JR
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 1:7601 E. IMPERIAL HWY
Mailing Address - Street 2:HB-ROOM 117
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242
Mailing Address - Country:US
Mailing Address - Phone:562-401-6525
Mailing Address - Fax:562-803-5623
Practice Address - Street 1:7601 E. IMPERIAL HWY
Practice Address - Street 2:JPI DEPARTMENT OF SURGERY
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90242-6650
Practice Address - Country:US
Practice Address - Phone:562-401-7166
Practice Address - Fax:562-401-6247
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42826207P00000X
CAA042826207Y00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E51988Medicare UPIN
CAWA42826EMedicare PIN
CAP00379128Medicare PIN