Provider Demographics
NPI:1225011620
Name:ARASE, RANDAL PAUL (MD)
Entity Type:Individual
Prefix:MR
First Name:RANDAL
Middle Name:PAUL
Last Name:ARASE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:201 S ALVARADO ST
Mailing Address - Street 2:STE 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:STE 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
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-21
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA25418208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A254180Medicaid
CAA25418Medicare ID - Type Unspecified
CA00A254180Medicaid