Provider Demographics
NPI:1669487435
Name:FARROHI, FARIDEH (MD)
Entity Type:Individual
Prefix:DR
First Name:FARIDEH
Middle Name:
Last Name:FARROHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:865 COMSTOCK AVE
Mailing Address - Street 2:12B
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-2572
Mailing Address - Country:US
Mailing Address - Phone:310-859-7536
Mailing Address - Fax:
Practice Address - Street 1:18546 ROSCOE BLVD
Practice Address - Street 2:211
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4663
Practice Address - Country:US
Practice Address - Phone:818-885-8040
Practice Address - Fax:818-885-8355
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA36865208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics