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General NPI Number Information
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NPI Number | 1194053785
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Entity Type | Individual
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Provider Name | ROBIN ARASH HATAM D.O.
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Gender | Male
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Dates
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Enumeration Date | 11/20/2009
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Last Update Date | 08/30/2019
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Provider Practice Location Address
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Address Line | 3513 E 1ST ST
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City | LOS ANGELES
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State | CA
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Zip | 90063-4101
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Country | US
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Telephone | 323-859-2660
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Fax |
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Provider Business Mailing Address
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Address Line | 12900 PARK PLAZA DR STE 150
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City | CERRITOS
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State | CA
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Zip | 90703-9329
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Country | US
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Telephone | 562-977-4674
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 20A11018
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License Number State | CA
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