Provider Demographics
NPI:1841499571
Name:FARNAD, FARIBORZ AFRAMIYAN
Entity type:Individual
Prefix:DR
First Name:FARIBORZ
Middle Name:AFRAMIYAN
Last Name:FARNAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13320 RIVERSIDE DR STE 110
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2519
Mailing Address - Country:US
Mailing Address - Phone:818-989-4100
Mailing Address - Fax:818-538-8808
Practice Address - Street 1:13320 RIVERSIDE DR STE 110
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-2519
Practice Address - Country:US
Practice Address - Phone:818-989-4100
Practice Address - Fax:818-538-8808
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA504601223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD50460Medicaid