| Pantea Farhadi Md A Medical Corporation | |
|
8635 W 3rd St Ste 1065w Los Angeles CA 90048-4120 | |
| (818) 708-3750 | |
| Not Available |
| Full Name | Pantea Farhadi Md A Medical Corporation |
|---|---|
| Speciality | Psychiatric Hospital |
| Location | 8635 W 3rd St Ste 1065w, Los Angeles, California |
| Authorized Official Name and Position | Sorour Khalili (PSYCHIATRIST) |
| Authorized Official Contact | 8187083750 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pantea Farhadi Md A Medical Corporation 8635 W 3rd St Ste 1065w Los Angeles CA 90048-6105 Ph: (310) 483-9843 | Pantea Farhadi Md A Medical Corporation 8635 W 3rd St Ste 1065w Los Angeles CA 90048-4120 Ph: (818) 708-3750 |
| NPI Number | 1689943946 |
|---|---|
| Provider Enumeration Date | 12/15/2011 |
| Last Update Date | 08/13/2024 |
| Certification Date | 08/06/2024 |
| Medicare PECOS PAC ID | 6305011545 |
|---|---|
| Medicare Enrollment ID | O20111216000075 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689943946 | NPI | - | NPPES |
| Provider Name | Lisa Kahn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528008430 PECOS PAC ID: 9739111303 Enrollment ID: I20050902000543 |
| Provider Name | Pantea Farhadi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104077726 PECOS PAC ID: 6103981709 Enrollment ID: I20090216000050 |
| Provider Name | Ajmal Mohammad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700017712 PECOS PAC ID: 2365570504 Enrollment ID: I20100510000669 |
| Provider Name | Diana Kang |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215016985 PECOS PAC ID: 9133400534 Enrollment ID: I20161222001619 |
| Provider Name | Amelle Joseph Baptiste Porter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952946956 PECOS PAC ID: 9032545439 Enrollment ID: I20200203002389 |
| Provider Name | Nnamdi Ofoeze |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073151916 PECOS PAC ID: 8224465174 Enrollment ID: I20200305001909 |
| Provider Name | Marsha Nadine Martinez Macksa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932608866 PECOS PAC ID: 6507206620 Enrollment ID: I20240506003473 |
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