Provider Demographics
NPI:1760685515
Name:HORACIO F ARIZA MD
Entity Type:Organization
Organization Name:HORACIO F ARIZA MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HORACIO
Authorized Official - Middle Name:F
Authorized Official - Last Name:ARIZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-562-9770
Mailing Address - Street 1:PO BOX 176
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-0176
Mailing Address - Country:US
Mailing Address - Phone:323-600-4901
Mailing Address - Fax:661-702-9712
Practice Address - Street 1:9808 VENICE BLVD
Practice Address - Street 2:710
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-2732
Practice Address - Country:US
Practice Address - Phone:323-526-9770
Practice Address - Fax:661-702-9712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA20388207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1093802951OtherINDIVIDUAL NPI
CAA203880Medicaid
CA1093802951OtherINDIVIDUAL NPI
CAA20388Medicare ID - Type Unspecified