Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204E00000X | Oral & Maxillofacial Surgeon | A132714 | CA |
N | 207N00000X | Dermatologist | A132714 | CA |
N | 207ND0101X | MOHS-Micrographic Surgeon | A132714 | CA |
N | 207NS0135X | Procedural Dermatology | A132714 | CA |
N | 207YS0123X | Facial Plastic Surgeon | A132714 | CA |
N | 207YS0123X | Facial Plastic Surgeon | MD60365940 | WA |
N | 208200000X | Surgeon | A132714 | CA |
N | 208600000X | Surgeon | A132714 | CA |
NPI | 1932376514 |
---|---|
Provider Name | Dr. Farhad Ardeshirpour |
First Address | Irvine, CA 92614-0234 |
Second Address | Beverly Hills, CA 90211-2103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2008 |
Last Update Date | 22/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1932376514 | (05) | WA |