Healthcare Provider Details

I. General information

NPI: 1679397418
Provider Name (Legal Business Name): ARYA MEDICAL GROUP CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2024
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 BELMONT AVE STE 100
MENDOTA CA
93640-8231
US

IV. Provider business mailing address

121 BELMONT AVE STE 100
MENDOTA CA
93640-8231
US

V. Phone/Fax

Practice location:
  • Phone: 559-424-0610
  • Fax:
Mailing address:
  • Phone: 559-424-0610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALI RASHIDIAN
Title or Position: OWNER
Credential: MD
Phone: 559-424-0610