Kamron a Fariba DO Inc

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

KAMRON A FARIBA DO INC

Practice address

415 W Route 66 Ste 202
Glendora, CA 91740-4335

Phone

(626) 963-4467

NPI assigned

Jul 29, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Kamron A Fariba, DONPI 1407315864

Title

Ceo, Sole Owner

Phone

(408) 772-1795

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kamron Fariba, DO

  • Psychiatry Physician
  • Glendora, CA
  • NPI 1407315864
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1722211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1114756160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W ROUTE 66 STE 202",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404335",
            "telephone_number": "626-963-4467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W ROUTE 66 STE 202",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404335",
            "telephone_number": "626-963-4467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2705 S Diamond Bar Blvd Ste 238",
            "address_purpose": "LOCATION",
            "city": "Diamond Bar",
            "state": "CA",
            "postal_code": "917653554",
            "country_code": "US",
            "telephone_number": "909-860-2166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KAMRON A FARIBA DO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-29",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "FARIBA",
        "authorized_official_first_name": "KAMRON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO, SOLE OWNER",
        "authorized_official_telephone_number": "408-772-1795",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Glendora, CA
• Providers in Glendora, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.