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FARIBORZ MORTAZAVI M.D. NPI 1689782708


NPI Profile

NPI: 1689782708
Provider Name: FARIBORZ MORTAZAVI, M.D.
Classification:Internal Medicine - 207RH0003X
Entity Type: Individual

Specialization: Hematology & Oncology

Organization: PMK MEDICAL GROUP, INC.

PECOS Registration: Yes

Address:
1700 N ROSE AVE SUITE 320
OXNARD, CA
ZIP 93030
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Phone: (805) 485-8709

Fariborz Mortazavi, M.D. is a hematology and oncology internal medicine in Oxnard, CA with 27 years of experience. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. Fariborz Mortazavi, M.D. NPI is 1689782708. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1700 N ROSE AVE SUITE 320
OXNARD, CA
ZIP 93030-648
Phone: (805) 485-8709
Fax: (805) 485-5521

The NPI 1689782708 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 8/28/2006 and was last updated on 9/8/2016.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RH0003XInternal MedicineHematology & Oncology036-107982ILLINOISNo
2207RH0003XInternal MedicineHematology & OncologyA96026CALIFORNIAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1CB255229MEDICARE PINCALIFORNIA

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: 10/10/2021

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.