Rene Farahmandian, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA17092 Issued in CA

Practice address

2021 Santa Monica Blvd Ste 600E
Santa Monica, CA 90404-2166

Phone

(310) 828-2282

Fax

(310) 828-8504

NPI assigned

Jun 7, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fountain Resources, Inc.

  • Nutritionist
  • Beverly Hills, CA
  • NPI 1104151273
  NPD (past)

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

{
    "created_epoch": "1275868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275868800000",
    "number": "1407176910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 SANTA MONICA BLVD STE 600E",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042166",
            "telephone_number": "310-828-2282",
            "fax_number": "310-828-8504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 SANTA MONICA BLVD STE 600E",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042166",
            "telephone_number": "310-828-2282",
            "fax_number": "310-828-8504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARAHMANDIAN",
        "first_name": "RENE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-07",
        "last_updated": "2010-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA17092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yichun Michelle Fang, RN
• Nicole Fanucci
• Far East Holistic Health Care Center Inc
• Carole Farah, DDS
• Elham Farahmand, D.D.S
• Maryam Farazha, MD
• David N Farchadi, MD, MS, MS
• Farinoush Gaminchi DMD Inc
• Claire Hamilton Farmer, PA-C
• Marissa Farmon, PMHNP-BC

• Medical Physician Assistant in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2010; 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.