MEDICARE: ARASH AFARI PROFESSIONAL MEDICAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0200X	Radiology Clinic/Center

General Provider Information

NPI Number	:	1982861852
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARASH AFARI PROFESSIONAL MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	2355 WESTWOOD BLVD
Second Line	:	STE.259
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-2109
Country	:	US
Telephone Number	:	180-062-6831
Fax Number	:	180-065-0061

Provider Business Practice Location Address
First Line	:	2355 WESTWOOD BLVD
Second Line	:	STE.259
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-2109
Country	:	US
Telephone Number	:	180-062-6831
Fax Number	:	180-065-0061

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ARASH AFARI
Credential	:	M.D.
Telephone Number	:	18006268315

Provider Enumeration Date	:	05/19/2008
Last Update Date	:	05/19/2008

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