Provider Demographics
NPI:1013222066
Name:ARIANJAM, AFSHIN (MD)
Entity Type:Individual
Prefix:DR
First Name:AFSHIN
Middle Name:
Last Name:ARIANJAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 E ARTESIA ST STE 255
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-2921
Mailing Address - Country:US
Mailing Address - Phone:909-596-4346
Mailing Address - Fax:909-596-4344
Practice Address - Street 1:160 E ARTESIA ST STE 255
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-2921
Practice Address - Country:US
Practice Address - Phone:909-596-4346
Practice Address - Fax:909-596-4344
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-15
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA113834207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty