Provider Demographics
NPI:1104102151
Name:UROLOGY OF SOUTHBAY INC.
Entity type:Organization
Organization Name:UROLOGY OF SOUTHBAY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/UROLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:FARHAD
Authorized Official - Middle Name:B
Authorized Official - Last Name:NOWZARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-921-1100
Mailing Address - Street 1:3400 LOMITA BLVD STE 502
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4988
Mailing Address - Country:US
Mailing Address - Phone:310-921-1100
Mailing Address - Fax:
Practice Address - Street 1:3400 LOMITA BLVD STE 502
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4988
Practice Address - Country:US
Practice Address - Phone:310-921-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-21
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71464261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty