Healthcare Provider Details

I. General information

NPI: 1720065121
Provider Name (Legal Business Name): ARTHUR H LOUSSARARIAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2005
Last Update Date: 11/05/2021
Certification Date: 11/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26800 CROWN VALLEY PKWY SUITE 120
MISSION VIEJO CA
92691-6384
US

IV. Provider business mailing address

26522 LA ALAMEDA SUITE 120
MISSION VIEJO CA
92691-6330
US

V. Phone/Fax

Practice location:
  • Phone: 949-364-3388
  • Fax: 949-364-5026
Mailing address:
  • Phone: 949-282-1671
  • Fax: 949-367-0518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberG75082
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: