Healthcare Provider Details

I. General information

NPI: 1083932255
Provider Name (Legal Business Name): ARIANA MARIE NELSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN MARIE MARCINIEC

II. Dates (important events)

Enumeration Date: 05/12/2010
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19200 JAMBOREE RD
IRVINE CA
92612-2570
US

IV. Provider business mailing address

101 THE CITY DR S
ORANGE CA
92868-3201
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-8888
  • Fax:
Mailing address:
  • Phone: 714-456-8888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA137655
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberA137655
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: