Provider Demographics
NPI:1134312366
Name:RANDAL PAUL ARASE MD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:RANDAL PAUL ARASE MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RANDAL
Authorized Official - Middle Name:P
Authorized Official - Last Name:ARASE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-484-2000
Mailing Address - Street 1:201 S ALVARADO ST
Mailing Address - Street 2:#716
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-2392
Mailing Address - Country:US
Mailing Address - Phone:213-484-2000
Mailing Address - Fax:213-484-9716
Practice Address - Street 1:201 S ALVARADO ST
Practice Address - Street 2:#716
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-2392
Practice Address - Country:US
Practice Address - Phone:213-484-2000
Practice Address - Fax:213-484-9716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA25418208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA83247Medicare UPIN