Provider Demographics
NPI:1316083199
Name:FARJAMI, SAFOORA (DC)
Entity type:Individual
Prefix:
First Name:SAFOORA
Middle Name:
Last Name:FARJAMI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 N MOORPARK RD STE 301
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-4437
Mailing Address - Country:US
Mailing Address - Phone:805-371-5610
Mailing Address - Fax:805-371-5611
Practice Address - Street 1:166 N MOORPARK RD STE 301
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-4437
Practice Address - Country:US
Practice Address - Phone:805-371-5610
Practice Address - Fax:805-371-5611
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28228111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor