Provider Demographics
NPI:1992080618
Name:FARNAD, SHAHBAZ A (MD)
Entity type:Individual
Prefix:DR
First Name:SHAHBAZ
Middle Name:A
Last Name:FARNAD
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 1:5757 WILSHIRE BLVD STE PR2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-3689
Mailing Address - Country:US
Mailing Address - Phone:323-433-7744
Mailing Address - Fax:323-433-7716
Practice Address - Street 1:5757 WILSHIRE BLVD STE PR2
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-3689
Practice Address - Country:US
Practice Address - Phone:323-433-7744
Practice Address - Fax:323-433-7716
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-13
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY274946207LP2900X
CAA1496336208VP0014X
IL125059273207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology