Healthcare Provider Details

I. General information

NPI: 1750709440
Provider Name (Legal Business Name): ARA VEHIAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2014
Last Update Date: 08/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOAG DR
NEWPORT BEACH CA
92663
US

IV. Provider business mailing address

PO BOX 515412
LOS ANGELES CA
90051-6712
US

V. Phone/Fax

Practice location:
  • Phone: 949-764-5438
  • Fax: 949-764-5674
Mailing address:
  • Phone: 949-764-5438
  • Fax: 949-764-5430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA140469
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: