MARYAM FARAZHA MD NPI 1063416840

NPI Information

NPI: 1063416840
Provider Name: MARYAM FARAZHA, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Organization: PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION

PECOS Registration: Yes

Address:
1821 WILSHIRE BLVD STE 100
SANTA MONICA, CA
ZIP 90403
Phone: (310) 575-3100
Get Directions

Maryam Farazha, MD is a family medicine in Santa Monica, CA with 24 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Maryam Farazha, MD NPI is 1063416840. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1821 WILSHIRE BLVD STE 100
SANTA MONICA, CA
ZIP 90403-627
Phone: (310) 575-3100
Fax: (310) 575-3102

The NPI 1063416840 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/9/2005 and was last updated on 3/31/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		A101291	CALIFORNIA	Yes
2	207Q00000X	Family Medicine		D0060512	MARYLAND	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	K249 0002	OTHER	MARYLAND	CAREFIRST BLUE CHOICE
2	64147501	OTHER	MARYLAND	CAREFIRST BC/BS OF MD
3	8127890	OTHER	MARYLAND	MAMSI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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