Provider Demographics
NPI:1548230287
Name:ARYA, AFSHIN (MD)
Entity Type:Individual
Prefix:DR
First Name:AFSHIN
Middle Name:
Last Name:ARYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10470 OLD PLACERVILLE ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2530
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:785-368-0735
Practice Address - Street 1:THREE MEDICAL PLAZA DRIVE
Practice Address - Street 2:SUITE 140
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661
Practice Address - Country:US
Practice Address - Phone:916-781-1927
Practice Address - Fax:916-781-1787
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0430798207R00000X
CAC55423207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200269200DMedicaid
KS200269200DMedicaid
KS106618Medicare PIN