Lalezarzadeh, Fariborz
Lalezarzadeh, Fariborz is an individual health care provider with primary practice located at 164 W Hospitality Ln Ste 100 , San Bernardino CA 92408-3316. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Lalezarzadeh, Fariborz can be contacted via phone (909) 883-8834.Contact Information
Primary practice address
164 W Hospitality Ln Ste 100
San Bernardino CA 92408-3316
Phone: (909) 883-8834
Fax: (909) 644-4021
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | A8309 | California |
Profile Details
| NPI number | 1811004625 |
|---|---|
| LBN Legal business name | Lalezarzadeh, Fariborz |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 25th, 2006 |
| Last updated | Nov 8th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811004625 | NPPES |
| California | Other | 020A83090 | MEDICARE ID TYPE UNSPECIFIED |
| California | MEDICAID | GR0079700 | MEDICARE ID TYPE UNSPECIFIED |
| California | MEDICAID | 020A83090 | MEDICARE ID TYPE UNSPECIFIED |
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