Provider Demographics
NPI:1780988683
Name:FARAHMAND, DARYOUSH (MD)
Entity type:Individual
Prefix:DR
First Name:DARYOUSH
Middle Name:
Last Name:FARAHMAND
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 1:1825 LOMA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-1928
Mailing Address - Country:US
Mailing Address - Phone:310-859-7616
Mailing Address - Fax:
Practice Address - Street 1:14034 PIONEER BLVD
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-3900
Practice Address - Country:US
Practice Address - Phone:562-864-6999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43240208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice