Provider Demographics
NPI:1679502447
Name:NAEIM-MESHKINPOUR, FARZAN (MD)
Entity type:Individual
Prefix:DR
First Name:FARZAN
Middle Name:
Last Name:NAEIM-MESHKINPOUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5387
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90622-5387
Mailing Address - Country:US
Mailing Address - Phone:949-727-1232
Mailing Address - Fax:949-727-9615
Practice Address - Street 1:7901 WALKER ST
Practice Address - Street 2:
Practice Address - City:LA PALMA
Practice Address - State:CA
Practice Address - Zip Code:90623-1722
Practice Address - Country:US
Practice Address - Phone:949-727-1232
Practice Address - Fax:949-727-9615
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA306202251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA87424Medicare UPIN
CAWA30620AMedicare ID - Type Unspecified