Healthcare Provider Details

I. General information

NPI: 1336495597
Provider Name (Legal Business Name): SARA ELIZABETH ARIAN MD, MSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2012
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 SECOND AVE
WALTHAM MA
02451-1158
US

IV. Provider business mailing address

130 SECOND AVE
WALTHAM MA
02451-1158
US

V. Phone/Fax

Practice location:
  • Phone: 714-656-6877
  • Fax:
Mailing address:
  • Phone: 714-656-6877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberBP10041217
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberQ9280
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: