Provider Demographics
NPI:1134150444
Name:MELAMED, FARHAD JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:FARHAD
Middle Name:JOSEPH
Last Name:MELAMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 N ROBERTSON BLVD STE 115
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2121
Mailing Address - Country:US
Mailing Address - Phone:310-657-8585
Mailing Address - Fax:310-657-8484
Practice Address - Street 1:150 N ROBERTSON BLVD STE 115
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2121
Practice Address - Country:US
Practice Address - Phone:310-657-8585
Practice Address - Fax:310-657-8484
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA054672207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG24440Medicare UPIN
CAA54672BMedicare ID - Type Unspecified
CAWA54672CMedicare PIN