Fariborz Lalezarzadeh DO Inc

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

FARIBORZ LALEZARZADEH DO INC

Practice address

164 W Hospitality LN Ste 100
San Bernardino, CA 92408-3316

Phone

(909) 883-8834

Fax

(909) 644-4021

NPI assigned

Dec 23, 2009

Organization subpart

No

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

Authorized official

Name

Fariborz Lalezarzadeh, DONPI 1811004625

Title

President

Phone

(909) 883-8834

Specialties & licenses 2

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.

• Fariborz Lalezarzadeh, DO

  • Surgery Physician
  • San Bernardino, CA
  • NPI 1811004625
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1261526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667865600000",
    "number": "1285963124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E REDLANDS BLVD STE U506",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923736109",
            "telephone_number": "909-883-8834",
            "fax_number": "909-883-8834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 W HOSPITALITY LN STE 100",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083316",
            "telephone_number": "909-883-8834",
            "fax_number": "909-644-4021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARIBORZ LALEZARZADEH DO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-23",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A",
        "authorized_official_last_name": "LALEZARZADEH",
        "authorized_official_first_name": "FARIBORZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-883-8834",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "20A8309",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Services of San Bernardino
• Family Wellness Medical Corporation
• Jennifer Adel Farag, M.S.
• Neal Robert Farber, RPH
• Wagner De Luca Faria, DDS
• Athena Christine Farmer
• Leah Farmer
• Taryn Faulk
• Jessica Faust
• Fiyinfoluwa Fawibe, MD

• Surgery Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.