Individual provider Active NPI

Negeen Farmand, PA

  • Physician Assistant
  • Fullerton, CA
National Provider Identifier
1255530168
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18632 Issued in CA
Practice address
2720 N Harbor Blvd
Suite 130
Fullerton, CA 92835-2609
Phone
(714) 449-6230
Fax
(714) 449-1773
NPI assigned
Jul 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA18632 CA Primary

Addresses

Primary practice location

2720 N Harbor Blvd
Suite 130
Fullerton, CA 92835-2609

Mailing address

Dept La21190
Pasadena, CA 91190-1190
Phone (714) 449-4800

Other identifiers 1

IdentifierTypeStateIssuer
PA18632OtherCALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110531000376 CA Practitioner - Physician Assistant 4486831401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Los Angeles Free ClinicGroup PAC ID 5395886311, 26 clinicians

Practice addresses (Care Compare)

6043 Hollywood Blvd
Los Angeles, CA 90028-5411
Phone (323) 653-1990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA18632CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Los Angeles Free Clinic CurrentSince Dec 15, 2008 Accepting new patients
The Los Angeles Free Clinic CurrentSince Dec 15, 2008 Accepting new patients

Locations

6043 Hollywood Blvd
Los Angeles, CA 90028
Phone (323) 653-1990

8405 Beverly Blvd
West Hollywood, CA 90048
Phone (323) 653-1990

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": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1255530168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT LA21190",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911901190",
            "telephone_number": "714-449-4800",
            "fax_number": "714-449-4956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 N HARBOR BLVD",
            "address_2": "SUITE 130",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928352609",
            "telephone_number": "714-449-6230",
            "fax_number": "714-449-1773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARMAND",
        "first_name": "NEGEEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA18632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA18632",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

Verify at the official NPI Registry.