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General NPI Number Information
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NPI Number | 1568455269
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Entity Type | Individual
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Provider Name | ARDAVAN M ASLIE SR. MD
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Gender | Male
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Dates
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Enumeration Date | 08/26/2005
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Last Update Date | 10/08/2015
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Provider Practice Location Address
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Address Line | 1111 EXPOSITION BLVD BLDG 500B
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City | SACRAMENTO
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State | CA
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Zip | 95815-4314
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Country | US
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Telephone | 916-920-8811
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Fax | 916-920-8817
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Provider Business Mailing Address
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Address Line | 1111 EXPOSITION BLVD BLDG 500B
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City | SACRAMENTO
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State | CA
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Zip | 95815-4314
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Country | US
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Telephone | 916-920-8811
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Fax | 916-920-8817
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | A60518
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 14877
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License Number State | NV
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