Provider Demographics
NPI:1932198256
Name:ARCIA, JOHN M (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:ARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:255 E ORANGE GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1240
Mailing Address - Country:US
Mailing Address - Phone:818-848-5595
Mailing Address - Fax:818-484-2176
Practice Address - Street 1:255 E ORANGE GROVE AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1240
Practice Address - Country:US
Practice Address - Phone:818-848-5595
Practice Address - Fax:818-848-5576
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAE70558207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG70558OtherLIC
CAGR0069980Medicaid
CAVA2734449OtherDEA
CAG70558OtherLIC
CAVA2734449OtherDEA