Provider Demographics
NPI:1154416808
Name:FARAH, DANNY (MD)
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:
Last Name:FARAH
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 1:16133 VENTURA BLVD
Mailing Address - Street 2:SUITE 360
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2426
Mailing Address - Country:US
Mailing Address - Phone:818-986-6009
Mailing Address - Fax:818-986-2415
Practice Address - Street 1:16133 VENUTRA BLVD
Practice Address - Street 2:SUITE 360
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2426
Practice Address - Country:US
Practice Address - Phone:818-986-6009
Practice Address - Fax:818-986-2415
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72189207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A72189Medicaid
CAA72189Medicare ID - Type Unspecified
CA00A72189Medicaid
H83636Medicare UPIN