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General NPI Number Information
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NPI Number | 1174814701
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Entity Type | Individual
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Provider Name | ARISS DERHOVANESSIAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/30/2011
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Last Update Date | 09/24/2012
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Provider Practice Location Address
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Address Line | 10833 LE CONTE AVE UCLA CENTER FOR HEALTH SCIENCES 37-131, BOX 951690
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City | LOS ANGELES
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State | CA
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Zip | 90095-1690
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Country | US
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Telephone | 310-825-8599
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Fax | 310-794-7073
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Provider Business Mailing Address
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Address Line | 10833 LE CONTE AVE UCLA CENTER FOR HEALTH SCIENCES 37-131, BOX 951690
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City | LOS ANGELES
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State | CA
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Zip | 90095-1690
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Country | US
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Telephone | 310-825-8599
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Fax | 310-794-7073
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | A100344
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | A100344
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License Number State | CA
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