Provider Demographics
NPI:1477950905
Name:FARNAM-FARD, LENORA (PHARMD)
Entity type:Individual
Prefix:
First Name:LENORA
Middle Name:
Last Name:FARNAM-FARD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-4609
Mailing Address - Country:US
Mailing Address - Phone:310-883-5655
Mailing Address - Fax:
Practice Address - Street 1:2525 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-4609
Practice Address - Country:US
Practice Address - Phone:310-883-5655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-26
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71854183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1477950905OtherKAISER PERMANENTE