Provider Demographics
NPI:1366885345
Name:FAHRADYAN, ARTUR (MD)
Entity type:Individual
Prefix:
First Name:ARTUR
Middle Name:
Last Name:FAHRADYAN
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 1:911 HAMPSHIRE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-2833
Mailing Address - Country:US
Mailing Address - Phone:805-885-0801
Mailing Address - Fax:805-885-0802
Practice Address - Street 1:911 HAMPSHIRE RD STE 1
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2833
Practice Address - Country:US
Practice Address - Phone:805-418-9891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA256519208600000X
CAA137921208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery