Provider Demographics
NPI:1659484566
Name:ARAKEL, ARTOON (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTOON
Middle Name:
Last Name:ARAKEL
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 1:1030 S GLENDALE AVE STE 407
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-2866
Mailing Address - Country:US
Mailing Address - Phone:818-543-7553
Mailing Address - Fax:818-543-0985
Practice Address - Street 1:1030 S GLENDALE AVE STE 407
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-2866
Practice Address - Country:US
Practice Address - Phone:818-543-7553
Practice Address - Fax:818-543-0985
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49849207Q00000X, 207RG0100X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A498491Medicaid
CA954706753OtherEIN
CAA49849Medicare ID - Type UnspecifiedMEDICARE
CA954706753OtherEIN