Individual
FARHAD MAZDISNIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 DUARTE RD, DUARTE, CA 91010-3012
(626) 256-4673
Mailing address
PO BOX 512185, LOS ANGELES, CA 90051-0185
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
18260
NH
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
A64550
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD2019-0989
NM
207RP1001X
Pulmonary Disease Physician
18260
NH
207RP1001X
Pulmonary Disease Physician
Primary
A64550
CA
207RP1001X
Pulmonary Disease Physician
MD2019-0989
NM
Other
Enumeration date
11/01/2006
Last updated
04/20/2022
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