Provider Demographics
NPI:1447329982
Name:ZANDPOUR, FARROKH (MD)
Entity type:Individual
Prefix:
First Name:FARROKH
Middle Name:
Last Name:ZANDPOUR
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 1:14915 BURBANK BLVD
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-3610
Mailing Address - Country:US
Mailing Address - Phone:818-909-7111
Mailing Address - Fax:818-909-0423
Practice Address - Street 1:14915 BURBANK BLVD
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-3610
Practice Address - Country:US
Practice Address - Phone:818-909-7111
Practice Address - Fax:818-909-0423
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA353572085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA35357Medicare UPIN