=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740241298
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ARNOLD CHANNING MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/31/2006
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5420 LINDLEY AVE #19
-----------------------------------------------------
City | ENCINO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91316-1957
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-776-1311
-----------------------------------------------------
Fax | 818-773-7501
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5420 LINDLEY AVE #19
-----------------------------------------------------
City | ENCINO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91316-1957
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-776-1311
-----------------------------------------------------
Fax | 818-773-7501
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207ZC0500X
-----------------------------------------------------
Taxonomy Name | Cytopathology Physician
-----------------------------------------------------
License Number | G5734
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207ZP0102X
-----------------------------------------------------
Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
-----------------------------------------------------
License Number | G5734
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------