Provider Demographics
NPI:1184690984
Name:FARID-MOAYER, MEHRAN (MD)
Entity type:Individual
Prefix:DR
First Name:MEHRAN
Middle Name:
Last Name:FARID-MOAYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 EL CAMINO REAL
Mailing Address - Street 2:SUITE 150
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-3224
Mailing Address - Country:US
Mailing Address - Phone:650-697-5367
Mailing Address - Fax:650-697-3843
Practice Address - Street 1:1720 EL CAMINO REAL
Practice Address - Street 2:SUITE 150
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3224
Practice Address - Country:US
Practice Address - Phone:650-697-5367
Practice Address - Fax:650-697-3843
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA66203207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A662033Medicare PIN
CAH96510Medicare UPIN