Provider Demographics
NPI:1578540415
Name:ARIZA, JOHN A (DPM)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:A
Last Name:ARIZA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 33880
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89533-3880
Mailing Address - Country:US
Mailing Address - Phone:775-355-1001
Mailing Address - Fax:775-355-8216
Practice Address - Street 1:343 ELM ST
Practice Address - Street 2:SUITE 302
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4540
Practice Address - Country:US
Practice Address - Phone:775-355-1001
Practice Address - Fax:775-355-8216
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-30
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9502213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002116003Medicaid
U37756Medicare UPIN
NV3910880001Medicare ID - Type Unspecified