Provider Demographics
NPI:1447343496
Name:ASFOUR, FAREED RAMZI (MD)
Entity type:Individual
Prefix:DR
First Name:FAREED
Middle Name:RAMZI
Last Name:ASFOUR
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 1:1141 CATALINA DR # 194
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-5928
Mailing Address - Country:US
Mailing Address - Phone:775-364-0900
Mailing Address - Fax:925-226-4007
Practice Address - Street 1:5176 HILL RD E
Practice Address - Street 2:
Practice Address - City:LAKEPORT
Practice Address - State:CA
Practice Address - Zip Code:95453-6357
Practice Address - Country:US
Practice Address - Phone:628-600-3589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71648207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A716480Medicaid
CAA71648OtherSTATE LICENSE
CAA71648OtherSTATE LICENSE
CA00A716482Medicare PIN
CAA71648OtherSTATE LICENSE
CA00A716481Medicare PIN