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Provider Information for 1013269000



DR. FARZAN ALAMIRAD DDS

Gender: MALE

Individual NPI: 1013269000

Calendar   Last Updated:  2012-11-08
  Certification Date: 

Details

Name Value
NPI 1013269000
Enumeration Date 2012-10-15
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 15643 SHERMAN WAY SUITE 300
VAN NUYS, CA 91406-4135
United States

Phone: 858-344-0190 | Fax:
View Map External Link
Primary Practice Address 15643 SHERMAN WAY SUITE 300
VAN NUYS, CA 91406-4135
United States

Phone: 858-344-0190 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist CA 61435