Individual
GHOLAM H FARBOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 S CENTRAL AVE, SUITE 221, GLENDALE, CA 91204-2530
(818) 242-0475
(818) 662-0260
Mailing address
1500 S CENTRAL AVE, SUITE 221, GLENDALE, CA 91204-2530
(818) 242-0475
(818) 662-0260
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C42647
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C426470
—
CA
Enumeration date
07/22/2006
Last updated
07/08/2007
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