Provider Demographics
NPI:1982686549
Name:MEHR, MEHRDAD FARHANG (MD)
Entity type:Individual
Prefix:DR
First Name:MEHRDAD
Middle Name:FARHANG
Last Name:MEHR
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 1:27 W ANAPAMU ST # 433
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-3107
Mailing Address - Country:US
Mailing Address - Phone:805-705-1608
Mailing Address - Fax:805-249-1299
Practice Address - Street 1:101 W ARRELLAGA ST STE E
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-5948
Practice Address - Country:US
Practice Address - Phone:617-414-5170
Practice Address - Fax:617-414-3803
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-18
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA152593208000000X, 2080P0203X
CAC553902080P0203X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3186237Medicaid
G44951Medicare UPIN
MA3186237Medicaid