Provider Demographics
NPI:1962449702
Name:PARSA, FOROUGH (MD)
Entity Type:Individual
Prefix:
First Name:FOROUGH
Middle Name:
Last Name:PARSA
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 1:2925 SYCAMORE DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-1207
Mailing Address - Country:US
Mailing Address - Phone:805-522-1818
Mailing Address - Fax:805-522-3909
Practice Address - Street 1:2925 SYCAMORE DR
Practice Address - Street 2:SUITE 300
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-1207
Practice Address - Country:US
Practice Address - Phone:805-522-1818
Practice Address - Fax:805-522-3909
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA29656207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A296560OtherBLUESHIELD OF CALIFORNIA
CA00A296560Medicaid
CA00A296560Medicaid
CAA29656Medicare ID - Type Unspecified