Provider Demographics
NPI:1225783467
Name:ARISE DME
Entity Type:Organization
Organization Name:ARISE DME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:WASIF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-212-3147
Mailing Address - Street 1:400 RAMONA AVE STE 212A
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-1443
Mailing Address - Country:US
Mailing Address - Phone:951-212-3147
Mailing Address - Fax:
Practice Address - Street 1:400 RAMONA AVE STE 212A
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-1443
Practice Address - Country:US
Practice Address - Phone:951-212-3147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1639661127Medicaid