# SHABAN AZAR FARR, MD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942534987
- **Authorized official:** MR. SHABAN AZAR FARR MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (818) 360-2800

## Contact information

- **Practice address:** 18541 SHERMAN WAY, \#101, RESEDA, CA 91335
- **Practice address phone:** (818) 996-9479
- **Practice address fax:** (818) 363-2100
- **Mailing address:** 18541 SHERMAN WAY, \#101, RESEDA, CA 91335
- **Mailing address phone:** (818) 360-2800
- **Mailing address fax:** (818) 363-2100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | A32840 | CA | Yes |

## Other

- **Enumeration date:** 09/23/2009
- **Last updated:** 09/23/2009