Provider Demographics
NPI:1285750471
Name:ARALICA, IVAN (MD)
Entity type:Individual
Prefix:
First Name:IVAN
Middle Name:
Last Name:ARALICA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4126 TECHNOLOGY WAY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-2009
Mailing Address - Country:US
Mailing Address - Phone:775-687-7573
Mailing Address - Fax:775-687-7544
Practice Address - Street 1:1675 AVENUE F
Practice Address - Street 2:
Practice Address - City:ELY
Practice Address - State:NV
Practice Address - Zip Code:89301-2520
Practice Address - Country:US
Practice Address - Phone:775-289-1671
Practice Address - Fax:775-289-1699
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV39622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVWJBJZMedicare ID - Type UnspecifiedGROUP NUMBER