Organization Active NPI

Ali Farrokh, MD, Inc

  • Pulmonary Disease Physician
  • Thousand Oaks, CA
National Provider Identifier
1255860490
Registry record updated Jul 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
A117693 Issued in CA
Legal business name
ALI FARROKH, MD, INC
Practice address
555 Marin St Ste 110
Thousand Oaks, CA 91360
Phone
(805) 496-0440
Fax
(805) 496-9808
NPI assigned
Jun 10, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2018

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

Authorized official

Name
Dr. Ali Farrokh, MDNPI 1164750170
Title
Ceo
Phone
(310) 909-3469

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X A117693 CA Primary

Addresses

Primary practice location

555 Marin St Ste 110
Thousand Oaks, CA 91360

Mailing address

555 Marin St Ste 110
Thousand Oaks, CA 91360-4102
Phone (310) 909-3469

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170720000827 CA Part B Supplier - Clinic/Group Practice 1759651912 Receives reassigned benefits from 1 practitioner
Practice locations: Valencia, CA; Thousand Oaks, CA

National Provider Directory

National Provider Directory

Locations

555 Marin St
Ste 110
Thousand Oaks, CA 91360
Phone (805) 496-0440

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1497052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531785600000",
    "number": "1255860490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 MARIN ST STE 110",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913604102",
            "telephone_number": "310-909-3469",
            "fax_number": "805-496-9808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 MARIN ST STE 110",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "91360",
            "telephone_number": "805-496-0440",
            "fax_number": "805-496-9808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALI FARROKH, MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-10",
        "last_updated": "2018-07-17",
        "status": "A",
        "authorized_official_last_name": "FARROKH",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-909-3469",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A117693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2018; 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.