Healthcare Provider Details

I. General information

NPI: 1295027290
Provider Name (Legal Business Name): ARPIE MADENLIAN RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2011
Last Update Date: 08/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2102 BUSINESS CENTER DR SUITE 130
IRVINE CA
92612-1001
US

IV. Provider business mailing address

2445 MARSEILLES WAY
COSTA MESA CA
92627-1417
US

V. Phone/Fax

Practice location:
  • Phone: 714-319-6216
  • Fax: 949-574-4118
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: