| Kevin Farnam, M.d., Inc. | |
|
65 N Madison Ave Ste 202 Pasadena CA 91101-5248 | |
| (626) 793-2246 | |
| (844) 272-2073 |
| Full Name | Kevin Farnam, M.d., Inc. |
|---|---|
| Speciality | Allergy & Immunology |
| Location | 65 N Madison Ave Ste 202, Pasadena, California |
| Authorized Official Name and Position | Kevin Farnam (PRESIDENT) |
| Authorized Official Contact | 6267932246 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin Farnam, M.d., Inc. 65 N Madison Ave Ste 202 Pasadena CA 91101-5248 Ph: (626) 793-2246 | Kevin Farnam, M.d., Inc. 65 N Madison Ave Ste 202 Pasadena CA 91101-5248 Ph: (626) 793-2246 |
| NPI Number | 1083076442 |
|---|---|
| Provider Enumeration Date | 03/24/2016 |
| Last Update Date | 08/25/2016 |
| Medicare PECOS PAC ID | 1052603032 |
|---|---|
| Medicare Enrollment ID | O20160712002061 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083076442 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | A110001 (California) | Secondary |
| 207KA0200X | Allergy & Immunology - Allergy | A110001 (California) | Primary |
| Provider Name | Kevin S Farnam |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1598092330 PECOS PAC ID: 9133252448 Enrollment ID: I20100805001013 |
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