Healthcare Provider Details

I. General information

NPI: 1447392246
Provider Name (Legal Business Name): ARASH ARUN SADEGHIAN O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 12/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 RIMPAU AVE SUITE B-104
CORONA CA
92881-3225
US

IV. Provider business mailing address

1501 RIMPAU AVE SUITE B-104
CORONA CA
92881-3225
US

V. Phone/Fax

Practice location:
  • Phone: 951-898-2010
  • Fax:
Mailing address:
  • Phone: 951-898-2010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number12354T
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number12354T
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number12354T
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number12354T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: