Provider Demographics
NPI:1457450439
Name:POLADIAN, ARA A (MD, FACOG)
Entity Type:Individual
Prefix:DR
First Name:ARA
Middle Name:A
Last Name:POLADIAN
Suffix:
Gender:M
Credentials:MD, FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10876 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91602-2236
Mailing Address - Country:US
Mailing Address - Phone:818-763-2992
Mailing Address - Fax:818-763-6054
Practice Address - Street 1:10876 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91602-2236
Practice Address - Country:US
Practice Address - Phone:818-763-2992
Practice Address - Fax:818-763-6054
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA40162207Q00000X, 207V00000X, 207VE0102X, 207VG0400X, 208600000X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA8880117Medicaid
CA8880117Medicaid
CAA85396Medicare UPIN