Provider Demographics
NPI:1154386399
Name:LIMONADI, FARHAD M (MD)
Entity type:Individual
Prefix:
First Name:FARHAD
Middle Name:M
Last Name:LIMONADI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72780 COUNTRY CLUB DR STE A104
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-4150
Mailing Address - Country:US
Mailing Address - Phone:760-895-0639
Mailing Address - Fax:760-423-6339
Practice Address - Street 1:72780 COUNTRY CLUB DR STE A104
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-4150
Practice Address - Country:US
Practice Address - Phone:760-895-0639
Practice Address - Fax:760-423-6339
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA92257207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
A922570Medicare ID - Type Unspecified
I45999Medicare UPIN