Destiny Health Clinic LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

DESTINY HEALTH CLINIC LLC

Practice address

400 Plaza Dr
Folsom, CA 95630-4744

Phone

(916) 235-3601

Fax

(916) 277-9034

NPI assigned

Feb 14, 2021

Last updated

Feb 14, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kamyar Farhangfar, MDNPI 1821145426

Title

Owner

Phone

(916) 235-3601

Specialties & licenses 1

Addresses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23152/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kamyar Farhangfar, M.D.

  • Internal Medicine Physician
  • Folsom, CA
  • NPI 1821145426
  NPD Authorized official

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

{
    "created_epoch": "1613260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613260800000",
    "number": "1326631086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 RILEY ST # 6241",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956309973",
            "telephone_number": "916-253-3601",
            "fax_number": "916-277-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PLAZA DR",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956304744",
            "telephone_number": "916-235-3601",
            "fax_number": "916-277-9034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTINY HEALTH CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-14",
        "last_updated": "2021-02-14",
        "certification_date": "2021-02-14",
        "status": "A",
        "authorized_official_last_name": "FARHANGFAR",
        "authorized_official_first_name": "KAMYAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-235-3601",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evelyn Deroos
• Anastasia P Dertlieva-Popova, PA
• Melissa Deryk
• Vaishali Desai, M.D.
• Taylor K Desilva
• Annika Elizabeth Dethlefs, FNP-BC
• Dennis Alan Devine, PH.D.
• Tia Lynne Dew
• Vandana Dhanda, FNP
• Amandeep Singh Dhillon, M.D.

• Internal Medicine Physician in Folsom, CA
• Providers in Folsom, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.