Provider Demographics
NPI:1689626251
Name:FARZAD, FARHAD (MD)
Entity Type:Individual
Prefix:
First Name:FARHAD
Middle Name:
Last Name:FARZAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:FARHAD
Other - Middle Name:MH
Other - Last Name:FARZAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:150 N. ROBERTSON BLVD.
Mailing Address - Street 2:SUITE # 316
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2145
Mailing Address - Country:US
Mailing Address - Phone:310-247-8282
Mailing Address - Fax:310-247-1418
Practice Address - Street 1:150 N. ROBERTSON BLVD.
Practice Address - Street 2:SUITE # 316
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2145
Practice Address - Country:US
Practice Address - Phone:310-247-8282
Practice Address - Fax:310-247-1418
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA46404207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology