Provider Demographics
NPI:1285750372
Name:ARTOON ARAKEL MD PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:ARTOON ARAKEL MD PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTOON
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAKEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-543-7553
Mailing Address - Street 1:1030 S GLENDALE AVE STE 407
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-2866
Mailing Address - Country:US
Mailing Address - Phone:818-543-7553
Mailing Address - Fax:818-543-0985
Practice Address - Street 1:1030 S GLENDALE AVE STE 407
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-2866
Practice Address - Country:US
Practice Address - Phone:818-543-7553
Practice Address - Fax:818-543-0985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49849174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1659484566OtherPHYSICIAN'S NPI
CA00A498491Medicaid
CAE96959Medicare UPIN
CA1659484566OtherPHYSICIAN'S NPI