Provider Demographics
NPI:1326533969
Name:AIINEHSAZIAN, ARASH ADAM
Entity Type:Individual
Prefix:MR
First Name:ARASH
Middle Name:ADAM
Last Name:AIINEHSAZIAN
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 1:5127 SHEARIN AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-1215
Mailing Address - Country:US
Mailing Address - Phone:314-814-1392
Mailing Address - Fax:
Practice Address - Street 1:135 N PARK VIEW ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-5215
Practice Address - Country:US
Practice Address - Phone:213-487-9804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker