Provider Demographics
NPI: | 1194063537 |
---|---|
Name: | ARASH YAGHOOBIAN M.D. CORP |
Entity type: | Organization |
Organization Name: | ARASH YAGHOOBIAN M.D. CORP |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | BILLER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | RAYMOND |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ISKANDER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 818-585-9269 |
Mailing Address - Street 1: | 5651 SEPULVEDA BLVD STE 201 |
Mailing Address - Street 2: | |
Mailing Address - City: | SHERMAN OAKS |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 91411-2954 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 5651 SEPULVEDA BLVD STE 201 |
Practice Address - Street 2: | |
Practice Address - City: | SHERMAN OAKS |
Practice Address - State: | CA |
Practice Address - Zip Code: | 91411-2954 |
Practice Address - Country: | US |
Practice Address - Phone: | 310-755-0306 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2013-01-18 |
Last Update Date: | 2020-01-31 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | A115226 | 207X00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Single Specialty |