Provider Demographics
NPI:1194802140
Name:FARBAKHSH, NASRIN (MD)
Entity type:Individual
Prefix:MRS
First Name:NASRIN
Middle Name:
Last Name:FARBAKHSH
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 PAULARINO AVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-2940
Mailing Address - Country:US
Mailing Address - Phone:714-547-7575
Mailing Address - Fax:714-547-8881
Practice Address - Street 1:720 PAULARINO AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-2940
Practice Address - Country:US
Practice Address - Phone:714-547-7575
Practice Address - Fax:714-547-8881
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2025-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA48188207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E92721Medicare UPIN
CAW14517Medicare ID - Type Unspecified