Provider Demographics
NPI:1306847827
Name:ARAB, MOHAMMAD K (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:K
Last Name:ARAB
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 1:2410 COMMERCE TRL
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:CA
Mailing Address - Zip Code:92251-4003
Mailing Address - Country:US
Mailing Address - Phone:760-355-8500
Mailing Address - Fax:760-355-8558
Practice Address - Street 1:2410 COMMERCE TRL
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:CA
Practice Address - Zip Code:92251-4003
Practice Address - Country:US
Practice Address - Phone:760-355-8500
Practice Address - Fax:760-355-8558
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39192207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A391920OtherBLUE SHIELD
CA00A391920OtherMEDI CAL
CA00A391920OtherBLUE SHIELD
CAB29052Medicare UPIN