Provider Demographics
NPI:1629076088
Name:PAI, ARAVIND (MD)
Entity Type:Individual
Prefix:
First Name:ARAVIND
Middle Name:
Last Name:PAI
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:PO BOX 496084
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96049-6084
Mailing Address - Country:US
Mailing Address - Phone:530-243-3871
Mailing Address - Fax:530-244-5054
Practice Address - Street 1:1001 YUBA ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1112
Practice Address - Country:US
Practice Address - Phone:530-243-3871
Practice Address - Fax:530-244-5054
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-11
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA303192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
260048280Medicare ID - Type UnspecifiedRAILROAD MEDICARE
A26052Medicare UPIN
CA00A303190Medicare ID - Type UnspecifiedNHIC PART B CARRIER