| Fari G Kamalpour Do Inc | |
|
1049 Avenida Ladera San Dimas CA 91773-4308 | |
| (818) 730-1183 | |
| Not Available |
| Full Name | Fari G Kamalpour Do Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1049 Avenida Ladera, San Dimas, California |
| Authorized Official Name and Position | Fari G Kamalpour (OWNER) |
| Authorized Official Contact | 8187301183 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fari G Kamalpour Do Inc 1049 Avenida Ladera San Dimas CA 91773-4308 Ph: (818) 730-1183 | Fari G Kamalpour Do Inc 1049 Avenida Ladera San Dimas CA 91773-4308 Ph: (818) 730-1183 |
| NPI Number | 1922414101 |
|---|---|
| Provider Enumeration Date | 07/08/2014 |
| Last Update Date | 07/08/2014 |
| Medicare PECOS PAC ID | 0941429997 |
|---|---|
| Medicare Enrollment ID | O20140924000676 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922414101 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 20A11842 (California) | Primary |
| Provider Name | Fari G Kamalpour |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831327972 PECOS PAC ID: 5193975472 Enrollment ID: I20121022000790 |
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