Provider Demographics
NPI:1144707712
Name:FARAH, AMINA S
Entity type:Individual
Prefix:
First Name:AMINA
Middle Name:S
Last Name:FARAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29313 LYNN CT
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-6757
Mailing Address - Country:US
Mailing Address - Phone:619-301-6844
Mailing Address - Fax:
Practice Address - Street 1:29313 LYNN CT
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-6757
Practice Address - Country:US
Practice Address - Phone:619-301-6844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-25
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver