=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174553218
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MEHRDAD KEVIN ARIANI MD INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/04/2006
-----------------------------------------------------
Last Update Date | 02/13/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 18350 ROSCOE BLVD #400
-----------------------------------------------------
City | NORTHRIDGE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91325
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-678-4900
-----------------------------------------------------
Fax | 818-678-4900
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 18350 ROSCOE BLVD #400
-----------------------------------------------------
City | NORTHRIDGE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91325
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-678-4900
-----------------------------------------------------
Fax | 818-678-6610
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. MEHRDAD KEVIN ARIANI
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 818-678-4900
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RI0011X
-----------------------------------------------------
Taxonomy Name | Interventional Cardiology Physician
-----------------------------------------------------
License Number | A48708
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | A48708
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------