Provider Demographics
NPI:1326822768
Name:FARIDI, DAVID (CNMT, CT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:FARIDI
Suffix:
Gender:M
Credentials:CNMT, CT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 IRWIN ST STE 225A
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-3343
Mailing Address - Country:US
Mailing Address - Phone:415-300-2738
Mailing Address - Fax:
Practice Address - Street 1:851 IRWIN ST STE 225A
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-3343
Practice Address - Country:US
Practice Address - Phone:415-300-2738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARHN00003450156F00000X, 171W00000X, 207U00000X, 2085B0100X, 2085R0202X, 2471N0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471N0900XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistNuclear Medicine Technology
No156F00000XEye and Vision Services ProvidersTechnician/Technologist
No171W00000XOther Service ProvidersContractor
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology