Provider Demographics
NPI:1972821809
Name:YAGHOOBIAN, ARASH (MD)
Entity type:Individual
Prefix:DR
First Name:ARASH
Middle Name:
Last Name:YAGHOOBIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5651 SEPULVEDA BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-2953
Mailing Address - Country:US
Mailing Address - Phone:310-755-0306
Mailing Address - Fax:310-855-0753
Practice Address - Street 1:5651 SEPULVEDA BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91411-2953
Practice Address - Country:US
Practice Address - Phone:646-234-1698
Practice Address - Fax:310-855-0753
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-17
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY255760207XS0117X
CA115226207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA115226OtherCALIFORNIA MEDICAL LICENSE