Provider Demographics
NPI:1134390933
Name:PARVIZ FAHIMIAN MD, INC.
Entity type:Organization
Organization Name:PARVIZ FAHIMIAN MD, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PARVIZ
Authorized Official - Middle Name:D
Authorized Official - Last Name:FAHIMIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-888-7733
Mailing Address - Street 1:13563 VIA SAN REMO
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-1350
Mailing Address - Country:US
Mailing Address - Phone:909-465-9949
Mailing Address - Fax:
Practice Address - Street 1:435 N BEDFORD DR STE 313
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4358
Practice Address - Country:US
Practice Address - Phone:310-888-7733
Practice Address - Fax:310-888-7783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA0523372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA52337Medicare PIN
CADQ505AMedicare PIN
CAF76806Medicare UPIN