Healthcare Provider Details

I. General information

NPI: 1093011934
Provider Name (Legal Business Name): ARASH ALBORZI MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2011
Last Update Date: 03/03/2020
Certification Date: 03/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 WILSON TER STE 310
GLENDALE CA
91206-4073
US

IV. Provider business mailing address

PO BOX 29159
LOS ANGELES CA
90029-0159
US

V. Phone/Fax

Practice location:
  • Phone: 818-550-1998
  • Fax:
Mailing address:
  • Phone: 818-550-1998
  • Fax: 818-660-1364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberA89523
License Number StateCA

VIII. Authorized Official

Name: MELODY ALBORZI
Title or Position: OFFICE MANAGER
Credential: ETC
Phone: 818-550-1998