Provider Demographics
NPI:1245277789
Name:FARSHIDI, ELAHEH ELLIE (MD)
Entity type:Individual
Prefix:DR
First Name:ELAHEH
Middle Name:ELLIE
Last Name:FARSHIDI
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:PO BOX 7277
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92658-7277
Mailing Address - Country:US
Mailing Address - Phone:714-337-4780
Mailing Address - Fax:
Practice Address - Street 1:925 S EUCLID ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92802-1522
Practice Address - Country:US
Practice Address - Phone:714-995-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1659312593207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A498010Medicaid
CA00A498010Medicaid