Healthcare Provider Details

I. General information

NPI: 1003056516
Provider Name (Legal Business Name): ARBI KHEMICHIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2009
Last Update Date: 02/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21320 HAWTHORNE BLVD. #104
TORRANCE CA
90503
US

IV. Provider business mailing address

10 CONGRESS ST STE 340
PASADENA CA
91105-3020
US

V. Phone/Fax

Practice location:
  • Phone: 310-543-2611
  • Fax:
Mailing address:
  • Phone: 626-796-5325
  • Fax: 626-796-5526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberN5775
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA117900
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: