Provider Demographics
NPI:1447392246
Name:SADEGHIAN, ARASH ARUN (OD)
Entity Type:Individual
Prefix:DR
First Name:ARASH
Middle Name:ARUN
Last Name:SADEGHIAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 RIMPAU AVE
Mailing Address - Street 2:SUITE B-104
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-3225
Mailing Address - Country:US
Mailing Address - Phone:951-898-2010
Mailing Address - Fax:
Practice Address - Street 1:1501 RIMPAU AVE
Practice Address - Street 2:SUITE B-104
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-3225
Practice Address - Country:US
Practice Address - Phone:951-898-2010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12354T152W00000X, 152WC0802X, 152WL0500X, 152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAER708AOtherGROUP PTAN
CAER708AOtherGROUP PTAN
CAU95856Medicare UPIN