Provider Demographics
NPI:1629065602
Name:MOMENI, ARASH (MD)
Entity Type:Individual
Prefix:DR
First Name:ARASH
Middle Name:
Last Name:MOMENI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ARASH
Other - Middle Name:
Other - Last Name:MOMENI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1746 COLE BLVD
Mailing Address - Street 2:STE 150
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80401-3267
Mailing Address - Country:US
Mailing Address - Phone:303-914-8800
Mailing Address - Fax:
Practice Address - Street 1:1746 COLE BLVD STE 150
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80401-3267
Practice Address - Country:US
Practice Address - Phone:303-914-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012368032085R0202X
CODR.00493372085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty