Healthcare Provider Details

I. General information

NPI: 1225011620
Provider Name (Legal Business Name): RANDAL PAUL ARASE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 12/19/2024
Certification Date: 02/20/2020
Deactivation Date: 11/27/2024
Reactivation Date: 12/19/2024

III. Provider practice location address

201 S ALVARADO ST STE 716
LOS ANGELES CA
90057-2392
US

IV. Provider business mailing address

201 S ALVARADO ST STE 716
LOS ANGELES CA
90057-2392
US

V. Phone/Fax

Practice location:
  • Phone: 213-484-2000
  • Fax: 213-484-9716
Mailing address:
  • Phone: 213-484-2000
  • Fax: 213-484-9716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA25418
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: