Individual
FARHAD EHTESSABIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25825 VERMONT AVE, HARBOR CITY, CA 90710-3518
(310) 325-5111
(626) 405-6768
Mailing address
393 E WALNUT ST, 3RD FLOOR - PHR SYSTEMS, PASADENA, CA 91188-0001
(626) 405-7914
(626) 405-6768
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
A34665
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A346650
—
CA
Enumeration date
07/03/2007
Last updated
07/08/2007
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