Provider Demographics
NPI:1023291465
Name:BAHMAN DANESHFAR MD, APMC
Entity type:Organization
Organization Name:BAHMAN DANESHFAR MD, APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BAHMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DANESHFAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-593-7285
Mailing Address - Street 1:302 ARABELLA BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6054
Mailing Address - Country:US
Mailing Address - Phone:337-593-7285
Mailing Address - Fax:
Practice Address - Street 1:302 ARABELLA BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6054
Practice Address - Country:US
Practice Address - Phone:337-593-7285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09493R2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LACE1608OtherRAILROAD MEDICARE
LA=========0OtherBLUE CROSS
LA5F870Medicare PIN
LA=========0OtherBLUE CROSS