Provider Demographics
NPI:1689829129
Name:HUMBOLDT MEDICAL SPECIALIST, INC
Entity Type:Organization
Organization Name:HUMBOLDT MEDICAL SPECIALIST, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ARYANPUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-937-6280
Mailing Address - Street 1:DEPT LA21190
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91185-1190
Mailing Address - Country:US
Mailing Address - Phone:714-449-4800
Mailing Address - Fax:
Practice Address - Street 1:1515 E ORANGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-6824
Practice Address - Country:US
Practice Address - Phone:714-449-4800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-25
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty