Provider Demographics
NPI:1639459654
Name:FARHAD SIGARI MD FACS PC
Entity Type:Organization
Organization Name:FARHAD SIGARI MD FACS PC
Other - Org Name:DEL REY ENT ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FARHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SIGARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-792-3914
Mailing Address - Street 1:4640 ADMIRALTY WAY
Mailing Address - Street 2:718
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-6621
Mailing Address - Country:US
Mailing Address - Phone:310-823-4444
Mailing Address - Fax:310-363-7085
Practice Address - Street 1:4640 ADMIRALTY WAY
Practice Address - Street 2:718
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-6621
Practice Address - Country:US
Practice Address - Phone:310-823-4444
Practice Address - Fax:310-363-7085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-22
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA112988207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA112988OtherMEDICAL BOARD