Provider Demographics
NPI:1063275477
Name:ARORA, SOURABH (MD)
Entity type:Individual
Prefix:
First Name:SOURABH
Middle Name:
Last Name:ARORA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13700 MARINA POINTE DR UNIT 1225
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-9268
Mailing Address - Country:US
Mailing Address - Phone:213-214-8738
Mailing Address - Fax:
Practice Address - Street 1:2222 SANTA MONICA BLVD STE 105
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2305
Practice Address - Country:US
Practice Address - Phone:213-214-8738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME166458207N00000X, 207W00000X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology