Provider Demographics
NPI:1164556247
Name:ARANIVA, JOSE RICARDO
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:RICARDO
Last Name:ARANIVA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 E 29TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90011-1930
Mailing Address - Country:US
Mailing Address - Phone:310-728-9149
Mailing Address - Fax:
Practice Address - Street 1:3320 W ADAMS BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90018-1838
Practice Address - Country:US
Practice Address - Phone:310-728-9149
Practice Address - Fax:323-596-2487
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker