Provider Demographics
NPI:1679928477
Name:ARA, ASHKAN F (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHKAN
Middle Name:F
Last Name:ARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SEYED FOAD
Other - Middle Name:
Other - Last Name:AHMADI OLOONABADI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11668 KIOWA AVE APT 102
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-6298
Mailing Address - Country:US
Mailing Address - Phone:857-206-2123
Mailing Address - Fax:
Practice Address - Street 1:200 WESTWOOD PLAZA
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-2903
Practice Address - Country:US
Practice Address - Phone:310-825-2448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program