Provider Demographics
NPI:1447272414
Name:SANI, FARAH (DO)
Entity type:Individual
Prefix:
First Name:FARAH
Middle Name:
Last Name:SANI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 MONTEVOIT CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95138-2256
Mailing Address - Country:US
Mailing Address - Phone:408-528-9467
Mailing Address - Fax:408-358-8605
Practice Address - Street 1:2516 SAMARITAN DR STE K
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-4108
Practice Address - Country:US
Practice Address - Phone:408-358-4300
Practice Address - Fax:408-358-4399
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A7108207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH10527Medicare UPIN
CA20A71081Medicare ID - Type Unspecified