Provider Demographics
NPI:1649253329
Name:FARAH, RAMEZ (MD)
Entity type:Individual
Prefix:
First Name:RAMEZ
Middle Name:
Last Name:FARAH
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 1:7150 W SUNSET RD
Mailing Address - Street 2:SUITE 201A
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-1981
Mailing Address - Country:US
Mailing Address - Phone:702-385-4342
Mailing Address - Fax:702-385-4346
Practice Address - Street 1:7150 W SUNSET RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-1981
Practice Address - Country:US
Practice Address - Phone:702-834-3961
Practice Address - Fax:702-586-1319
Is Sole Proprietor?:No
Enumeration Date:2005-11-27
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45707174400000X, 2085R0001X
NV139222085R0001X, 2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A457070Medicaid
NV1649253329Medicaid
CAWA45707FMedicare PIN
CA00A457073Medicare PIN
CAWA45707AMedicare PIN
CAWA45707KMedicare PIN
CAWA45707HMedicare PIN
NVGE284ZMedicare PIN
CAC42132Medicare UPIN
NV1649253329Medicaid
CA00A457070Medicaid
CAWA45707DMedicare PIN
CAWA45707CMedicare PIN
CA00A457072Medicare ID - Type Unspecified
CAWA45707EMedicare PIN