Victory, Farzan
Victory, Farzan is an individual health care provider with primary practice located at 601 Dr Martin Luther King Jr Ave Ne , Albuquerque NM 87102-3619. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Victory, Farzan can be contacted via phone (505) 298-0301.Contact Information
Primary practice address
601 Dr Martin Luther King Jr Ave Ne
Albuquerque NM 87102-3619
Phone: (505) 298-0301
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 2006-0380 | New Mexico |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 0101249264 | Virginia |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MD2012-0597 | New Mexico |
Profile Details
| NPI number | 1578602504 |
|---|---|
| LBN Legal business name | Victory, Farzan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 6th, 2007 |
| Last updated | Jul 19th, 2016 - about 9 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 | 1578602504 | NPPES |
| New Mexico | Other | NMA102940 | MEDICARE PTAN |
| New Mexico | MEDICAID | 70379807 | MEDICARE PTAN |
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