Provider Demographics
NPI:1508811803
Name:ARNDT, ROLF (MD)
Entity Type:Individual
Prefix:
First Name:ROLF
Middle Name:
Last Name:ARNDT
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:DEPT LA 21559
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91185-1559
Mailing Address - Country:US
Mailing Address - Phone:323-297-0670
Mailing Address - Fax:
Practice Address - Street 1:23929 MCBEAN PKWY
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-4466
Practice Address - Country:US
Practice Address - Phone:661-253-8705
Practice Address - Fax:661-253-8007
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA233282085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A233280OtherBLUE SHIELD OF CA
CA00A233280Medicaid
CAWA23328PMedicare PIN
CAWA23328EMedicare PIN
CAWA23328NMedicare PIN
CA00A233280Medicaid
CAWA23328OMedicare PIN