Healthcare Provider Details

I. General information

NPI: 1922171644
Provider Name (Legal Business Name): MANINDER P ARORA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 06/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 BROCKTON AVE SUITE #130
RIVERSIDE CA
92501-4068
US

IV. Provider business mailing address

4440 BROCKTON AVE SUITE #130
RIVERSIDE CA
92501-4068
US

V. Phone/Fax

Practice location:
  • Phone: 951-784-7444
  • Fax: 951-784-7474
Mailing address:
  • Phone: 951-784-7444
  • Fax: 951-784-7474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA42567
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberA42567
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: