Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | G080565 | CA |
Y | 208600000X | Surgeon | G080565 | CA |
N | 2086X0206X | Surgical Oncologist | G080565 | CA |
NPI | 1215035415 |
---|---|
Provider Name | Hany Farid |
First Address | Los Angeles, CA 90077-1364 |
Second Address | Mission Hills, CA 91345-1225 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 27/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G65211 | (02) | CA |