Provider Demographics
NPI:1891203089
Name:FAROKHI, FARYAR (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:FARYAR
Middle Name:
Last Name:FAROKHI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11533 SCRIPPS CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-3682
Mailing Address - Country:US
Mailing Address - Phone:785-917-0792
Mailing Address - Fax:
Practice Address - Street 1:3412 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-7134
Practice Address - Country:US
Practice Address - Phone:619-858-9974
Practice Address - Fax:619-858-0078
Is Sole Proprietor?:No
Enumeration Date:2018-01-22
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61871183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist