Provider Demographics
NPI:1194924266
Name:ALAVI-TEHRANI, ARASH (PT)
Entity type:Individual
Prefix:
First Name:ARASH
Middle Name:
Last Name:ALAVI-TEHRANI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20505 SHAKARI CIR
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92887-3252
Mailing Address - Country:US
Mailing Address - Phone:714-310-6626
Mailing Address - Fax:
Practice Address - Street 1:17801 IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-2362
Practice Address - Country:US
Practice Address - Phone:714-961-5483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT26713225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist