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General NPI Number Information
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NPI Number | 1508362401
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Entity Type | Individual
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Provider Name | ARIAN IRANNEJAD PT
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Gender | Male
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Dates
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Enumeration Date | 04/01/2018
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Last Update Date | 04/07/2018
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Provider Practice Location Address
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Address Line | 1211 W LA PALMA AVE STE 602
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City | ANAHEIM
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State | CA
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Zip | 92801-2813
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Country | US
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Telephone | 657-251-9210
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Fax | 657-202-2711
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Provider Business Mailing Address
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Address Line | 1642 ORCHARD DR APT B
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City | PLACENTIA
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State | CA
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Zip | 92870-7423
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Country | US
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Telephone | 858-539-9761
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 294431
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License Number State | CA
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