Provider Demographics
NPI:1578543443
Name:AIRAPETIAN, ARA (MD)
Entity Type:Individual
Prefix:DR
First Name:ARA
Middle Name:
Last Name:AIRAPETIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:801 S CHEVY CHASE DR
Mailing Address - Street 2:#20
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-4431
Mailing Address - Country:US
Mailing Address - Phone:323-256-4116
Mailing Address - Fax:323-478-9454
Practice Address - Street 1:1704 COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-1338
Practice Address - Country:US
Practice Address - Phone:323-256-4116
Practice Address - Fax:323-478-9454
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA86421208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI04794Medicare UPIN