MEDICARE: DR. ARA A POLADIAN M.D., F.A.C.O.G.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A40162	CA
2	207V00000X	Obstetrics & Gynecology Physician	A40162	CA
3	207VE0102X	Reproductive Endocrinology Physician	A40162	CA
4	207VG0400X	Gynecology Physician	A40162	CA
5	208600000X	Surgery Physician	A40162	CA
6	207VF0040X	Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician	A40162	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457450439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARA A POLADIAN M.D., F.A.C.O.G.

Provider Business Mailing Address
First Line	:	10876 RIVERSIDE DR
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91602-2236
Country	:	US
Telephone Number	:	818-763-2992
Fax Number	:	818-763-6054

Provider Business Practice Location Address
First Line	:	10876 RIVERSIDE DR
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91602-2236
Country	:	US
Telephone Number	:	818-763-2992
Fax Number	:	818-763-6054

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	06/16/2018

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