Individual
FARHAD KHORASHADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
27700 MEDICAL CENTER RD, RADIOLOGY DEPARTMENT, MISSION VIEJO, CA 92691-6426
(949) 364-7744
(949) 364-4233
Mailing address
DEPT LA 21789, PASADENA, CA 91185-1789
(949) 263-8620
(949) 263-1639
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A75718
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A757180
BLUE SHIELD
CA
05
—
00A757180
—
CA
Enumeration date
04/24/2006
Last updated
11/30/2007
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