Provider Demographics
NPI:1972311181
Name:SALEHI, FARZANEH (NP)
Entity type:Individual
Prefix:
First Name:FARZANEH
Middle Name:
Last Name:SALEHI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3155 MONTROSE AVE APT 317
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91214-3647
Mailing Address - Country:US
Mailing Address - Phone:747-477-4347
Mailing Address - Fax:
Practice Address - Street 1:11631 VICTORY BLVD STE 101
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3572
Practice Address - Country:US
Practice Address - Phone:818-764-8838
Practice Address - Fax:818-764-3032
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANPF95033134207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine