Provider Demographics
NPI:1912062936
Name:BARDI, FARIBA (DC)
Entity Type:Individual
Prefix:DR
First Name:FARIBA
Middle Name:
Last Name:BARDI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 TERMINO AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-2126
Mailing Address - Country:US
Mailing Address - Phone:562-494-8008
Mailing Address - Fax:562-494-8001
Practice Address - Street 1:1703 TERMINO AVE STE 107
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-2126
Practice Address - Country:US
Practice Address - Phone:562-494-8008
Practice Address - Fax:562-494-8001
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23736111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor