| Kamron a Fariba DO Inc | |
|
415 W Route 66 Ste 202 Glendora CA 91740-4335 | |
| (626) 963-4467 | |
| Not Available |
| Full Name | Kamron a Fariba DO Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 415 W Route 66 Ste 202, Glendora, California |
| Authorized Official Name and Position | Kamron a Fariba (CEO, SOLE OWNER) |
| Authorized Official Contact | 4087721795 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kamron a Fariba DO Inc 415 W Route 66 Ste 202 Glendora CA 91740-4335 Ph: (626) 963-4467 | Kamron a Fariba DO Inc 415 W Route 66 Ste 202 Glendora CA 91740-4335 Ph: (626) 963-4467 |
| NPI Number | 1114756160 |
|---|---|
| Provider Enumeration Date | 07/29/2024 |
| Last Update Date | 07/29/2024 |
| Certification Date | 07/29/2024 |
| Medicare PECOS PAC ID | 5193257657 |
|---|---|
| Medicare Enrollment ID | O20241022003005 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114756160 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (NU) | Primary |
| Provider Name | Kamron Fariba |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407315864 PECOS PAC ID: 2567825979 Enrollment ID: I20240605003220 |
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