Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 019023400 | IL |
NPI | 1003070756 |
---|---|
Provider Name | Frank Farokian |
First Address | Newport Beach, CA 92663-3304 |
Second Address | Newport Beach, CA 92663-3304 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2008 |
Last Update Date | 19/07/2021 |