| Mishel Farasatpour Md Inc | |
|
10966 W Pico Blvd Los Angeles CA 90064-2115 | |
| (310) 666-3288 | |
| Not Available |
| Full Name | Mishel Farasatpour Md Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 10966 W Pico Blvd, Los Angeles, California |
| Authorized Official Name and Position | Mishel Farasatpour (CEO/OWNER) |
| Authorized Official Contact | 3106663288 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mishel Farasatpour Md Inc Po Box 55517 Sherman Oaks CA 91413-0517 Ph: (310) 666-3288 | Mishel Farasatpour Md Inc 10966 W Pico Blvd Los Angeles CA 90064-2115 Ph: (310) 666-3288 |
| NPI Number | 1750962981 |
|---|---|
| Provider Enumeration Date | 04/19/2021 |
| Last Update Date | 04/19/2021 |
| Certification Date | 04/19/2021 |
| Medicare PECOS PAC ID | 2769891431 |
|---|---|
| Medicare Enrollment ID | O20210510001440 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750962981 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Mishel Farasatpour |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1841533767 PECOS PAC ID: 6406105089 Enrollment ID: I20180814004278 |
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