Farazha, Maryam
Farazha, Maryam is an individual health care provider with primary practice located at 1821 Wilshire Blvd Ste 100 , Santa Monica CA 90403-5627. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Farazha, Maryam can be contacted via phone (310) 575-3100.Contact Information
Primary practice address
1821 Wilshire Blvd Ste 100
Santa Monica CA 90403-5627
Phone: (310) 575-3100
Fax: (310) 575-3102
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | D0060512 | Maryland |
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | A101291 | California |
Profile Details
NPI number | 1063416840 |
---|---|
LBN Legal business name | Farazha, Maryam |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 9th, 2005 |
Last updated | Mar 31st, 2021 - about 3 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 | 1063416840 | NPPES |
Maryland | Other | 8127890 | MAMSI |
Maryland | Other | K249 0002 | MAMSI |
Maryland | Other | 64147501 | MAMSI |
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