Healthcare Provider Details

I. General information

NPI: 1174553218
Provider Name (Legal Business Name): MEHRDAD KEVIN ARIANI MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 02/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18350 ROSCOE BLVD #400
NORTHRIDGE CA
91325
US

IV. Provider business mailing address

18350 ROSCOE BLVD #400
NORTHRIDGE CA
91325
US

V. Phone/Fax

Practice location:
  • Phone: 818-678-4900
  • Fax: 818-678-4900
Mailing address:
  • Phone: 818-678-4900
  • Fax: 818-678-6610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA48708
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberA48708
License Number StateCA

VIII. Authorized Official

Name: DR. MEHRDAD KEVIN ARIANI
Title or Position: PRESIDENT
Credential: MD
Phone: 818-678-4900