Healthcare Provider Details

I. General information

NPI: 1831493394
Provider Name (Legal Business Name): ANWAR AND VASEEMA ARASTU M D INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2010
Last Update Date: 12/28/2020
Certification Date: 12/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12675 LA MIRADA BLVD SUITE 200
LA MIRADA CA
90638-2200
US

IV. Provider business mailing address

12675 LA MIRADA BLVD SUITE 200
LA MIRADA CA
90638-2200
US

V. Phone/Fax

Practice location:
  • Phone: 562-941-9853
  • Fax: 562-941-9683
Mailing address:
  • Phone: 562-941-9853
  • Fax: 562-941-9683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA44428
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA44427
License Number StateCA

VIII. Authorized Official

Name: ANWAR H ARASTU
Title or Position: PRESIDENT
Credential: MD
Phone: 562-941-9853