Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | A38193 | CA |
NPI | 1003985599 |
---|---|
Provider Name | Mr. Hormoz Farhat |
First Address | Van Nuys, CA 91405 |
Second Address | Van Nuys, CA 91405-3605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 03/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A32034 | (02) | CA |