Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 35185 | CA |
N | 2251X0800X | Physical Therapist - Orthopedic | 0314411 | NY |
NPI | 1043545924 |
---|---|
Provider Name | Dr. Rebecca Marie Farahat |
First Address | Tustin, CA 92782-1090 |
Second Address | Orange, CA 92867-5045 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2009 |
Last Update Date | 26/02/2014 |