Individual
IRSHAD H FARDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MBA
Contact information
Practice address
2167 PASETTA DR APT 1, SANTA CLARA, CA 95050-3249
(408) 204-8974
Mailing address
2167 PASETTA DR APT 1, SANTA CLARA, CA 95050-3249
(408) 204-8974
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
—
251S00000X
Community/Behavioral Health Agency
—
—
385H00000X
Respite Care
Primary
—
—
Other
Enumeration date
10/09/2020
Last updated
10/09/2020
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