Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | A52857 | CA |
NPI | 1053305979 |
---|---|
Provider Name | Charles Frank Farthing |
First Address | West Hollywood, CA 90046-6611 |
Second Address | Beverly Hills, CA 90211-2222 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A528570 | (05) | CA |
G17927 | (02) |