Healthcare Provider Details

I. General information

NPI: 1861599748
Provider Name (Legal Business Name): ANTONIO C. ARRIETA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 S MAIN ST PSF INFECTIOUS DISEASE
ORANGE CA
92868-3835
US

IV. Provider business mailing address

455 S MAIN ST PSF INFECTIOUS DISEASE
ORANGE CA
92868-3835
US

V. Phone/Fax

Practice location:
  • Phone: 714-532-8403
  • Fax: 714-289-4014
Mailing address:
  • Phone: 714-289-4511
  • Fax: 714-289-4788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License NumberA46432
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: