Individual provider Active NPI

Farzam Yazdanfar, D.C.

  • Chiropractor
  • Norwalk, CA
National Provider Identifier
1043795073
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
34283 Issued in CA
Practice address
12360 Firestone Blvd
Norwalk, CA 90650-4324
Phone
(866) 733-5924
NPI assigned
Sep 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 34283 CA Primary

Addresses

Primary practice location

12360 Firestone Blvd
Norwalk, CA 90650-4324

Mailing address

12360 Firestone Blvd
Norwalk, CA 90650-4324
Phone (866) 733-5924

Other practice location 1

180 E Main St Ste 106
Tustin, CA 92780-4459
Phone (714) 505-1901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200505001378 CA Practitioner - Chiropractic 0042641144 Practice locations: Tustin, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Chiropractic & Wellness Center Chiropractor Past Accepting new patients
Pacific Chiropractic & Wellness Center Inc PastSince Dec 21, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: farzam.yazdnafardc.p1@direct.jwch.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1043795073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12360 FIRESTONE BLVD",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906504324",
            "telephone_number": "866-733-5924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12360 FIRESTONE BLVD",
            "city": "NORWALK",
            "state": "CA",
            "postal_code": "906504324",
            "telephone_number": "866-733-5924"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 E Main St Ste 106",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927804459",
            "country_code": "US",
            "telephone_number": "714-505-1901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAZDANFAR",
        "first_name": "FARZAM",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-25",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "34283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.