Individual
DR. BABAK SANEI FARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
414 G ST, SUITE 108, MARYSVILLE, CA 95901-5663
(530) 749-6628
Mailing address
414 G ST, SUITE 108, MARYSVILLE, CA 95901-5663
(530) 749-6628
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A112750
CA
207RI0011X
Interventional Cardiology Physician
Primary
A112750
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0A1127500
BLUE SHIELD PIN #
CA
05
—
1225199805
—
CA
Enumeration date
12/13/2006
Last updated
10/25/2016
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