Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Maryam Farazha, MD

Individual provider Family Medicine Physician · NPI 1063416840

Maryam Farazha, MD is a Family Practice in Santa Monica, California. Qualified in 2000, 26 years ago. Practices with Providence Saint Johns Medical Foundation, a 285-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California and Maryland.

Years since qualifying
26
Licensed in
CA, MD
In the registry since
2005
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1821 Wilshire Blvd Ste 100
Santa Monica, CA 90403-5627
Phone: (310) 575-3100
Fax: (310) 575-3102
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence A101291 (CA)
Family Medicine Physician Taxonomy 207Q00000X · Licence D0060512 (MD)

Record details

NPI number1063416840
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 9, 2005
Last updated in NPPESMarch 31, 2021
Certification dateMarch 31, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Providence Saint Johns Medical Foundation — 285 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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