Provider Demographics
NPI:1699735282
Name:MAJIDI, FARZAD (MD)
Entity type:Individual
Prefix:DR
First Name:FARZAD
Middle Name:
Last Name:MAJIDI
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 1:700 SHADOW LN
Mailing Address - Street 2:SUITE 240
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106
Mailing Address - Country:US
Mailing Address - Phone:702-384-0022
Mailing Address - Fax:702-384-0529
Practice Address - Street 1:700 SHADOW LN
Practice Address - Street 2:SUITE 240
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106
Practice Address - Country:US
Practice Address - Phone:702-384-0022
Practice Address - Fax:702-384-0529
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0058795207R00000X
LAMD.203531207RC0000X
NV15506207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2105329Medicaid
MS04808702Medicaid
MDH77646Medicare UPIN
LA4Q1767061Medicare PIN