Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 95018182 | CA |
NPI | 1306518196 |
---|---|
Provider Name | Tannaz Farighi |
First Address | Orange, CA 92869-3204 |
Second Address | Orange, CA 92869-3204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2021 |
Last Update Date | 21/01/2022 |