Healthcare Provider Details

I. General information

NPI: 1518447689
Provider Name (Legal Business Name): RAZIEH SOLTANI ARABSHAHI MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2018
Last Update Date: 12/04/2020
Certification Date: 12/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 E GREEN ST STE 330
PASADENA CA
91106-2401
US

IV. Provider business mailing address

1209 FERNSIDE DR
LA CANADA CA
91011-2224
US

V. Phone/Fax

Practice location:
  • Phone: 626-449-4207
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number156592
License Number StateCA

VIII. Authorized Official

Name: DR. RAZIEH SOLTANI ARABSHAHI
Title or Position: PRESIDENT
Credential: MD
Phone: 626-660-5816